080600932
Z C
CITY OF CUPERTINO
�' �:�. � a>;'v >in•�5` �"� "`-''^���
-
BUILDING6IVISfON•• PERMITFbKonC�NTRAGTORINFORMATION
Bul1,Plldq'fi" RICH WY
ti
TBD — TO BE DETERMINED
08060093
WNERU'SUN7AM7E:
FE'Rh0'T ISSUE DATE
MESSINA 1989 LIVING TRUST
06/12/2008
riONE:
SANITARY NO, CONTROL NO.
ARCHITECTIENGINEER:
BUILDING PERMIT INFO
'BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
p
9 (commencing
1 herby affirm that 1 arm licensed under Provisions, of Chaptero
withS fion7000)ofDividon3ofthe Bmincvand Nofesdom Co .andmyiicc=is
REPLC CLST BND&FLR DRAIN, P—TRAP
I. full fare and cert 3
License&) Lica �}
DONE -RIGHT ROOTER AND PLUMBING PD BUS LIC 6/12/08
Dale Con
DELL
DECLARATION
As
._...
1 understand my plans shall h used as Public rceerN
Mail h use
..
j Lice sed Professional
OWNER -BUILDER DECLARATION
I hmhy affirm that 1 am caconm from the Contractors License Law for the
i fallowing won. (Section 7031-5, Business and Ihotesumns Cade: Any city or moot,
_
which tenuous a pemil on conswc4 ahq improve, demnitsh, or repair any suumure
! prior to its issuance. alsu requires the applicant for such permit to file a signed statement
' loContractor's LicevcLaw 9
Sq. Ft. Floor Area
Valuation
that he is licensed pursuant the provisions ofine(Chapter
$3807
(eammeneing with Scedon 70W) 9Division 3 of the Business and ProtestantsCodc) or
• Nat he u exempt therfr.n old the bub for the alleged cumpdon. Any vlolatla) of
32632041.tdli. N Number
Occupancy
Pane Y T yPe
Section 7031.5 by airy appllant for a permit mbjecu Ih applicant to it civil penalty of
not mom than lost hundred call. (M).
1, u owner of the property.. my employees with mgr an their sole compeuNan,
Required Inspections
will da the work. and the structure u not intended or offered for »k(Sec. 7044. Business
and Prolesdom Cade: The Contractors License Law dors cot apply to an owner of
ns
q p
property who builds.inprovos theme, aund whodaessuch.1chimselfor through his
,
owncmployw, provided shat such improvements art not intended moRered ferrate. If.
however, the Wilding. impnsemmt is sold wi bin one year of completion. the.
builder will have the burden of proving that he did not build . impram for purpose of
sale.).
❑ I. as awn. of the property am exclusively mnuacting with licensed conrrxl.s b
com ucl the proje. (Sec. 7014. Business and ProRsams Code:) Th Cmbumrs Li-
ccue taw it= not apply m an owner of property who builds or improves thereat, and .
who contracts for such projccu with a contractor(a) licensed pursuant to the Contrulors
Llame law.
❑ lamexcmptunder See .BdPCtnr Wiswon
wins Date
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under perWty of perjury ale of the fallowing decluatiortg
❑ 1 have and will maintain a Cmtificem of Comem ID utf-lour faWmkdsCompcm
station. u pmvided for by Section 3700 of the labor Code. for the performance of the
wart for which this permit is issued.
have and will maintain Workers Compensation lomranr, as ma,imd by Section
3-f00 of the labor Cale, for Ne performance of the work for which does Permit u issued.
'
My Workers CoRRpeusatim Imunldce carrier and Policy n��um�b�er ��..�y}--.���yyaa
/+
Cania:SUF7 %N� . C� PolicyN:Y,oum '&Q-,�:L�1s
1146
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu swim need not he completed itch permit is foronc hundred dollm (SIM)
.leu)
1 certify Nvl in the performance of to work for which this Norm, u issued, l shall ml
employ any person in any manrcrso as ur become subject an do Works"' Compensation
Laws of California. Data
Applicant
NOTICE TO APPLICANT. If, after making this Ceniftmu of Exemption, you should
bcerome subject in the Workers Cadnpcosiuon mervioons of the labor Codc, you most
forthwith comply with such pravuiom or this permit shall W dcemed tevakcd,
I
CONSTRUCTION LENDING AGENCY
1 heteby affirm that them is a couwctinn lending agony for the performance of
the work for which Nes Permit is issued (Sec. 3097, Civ. C.)
lenders Name
Lcndeh Address
1 certify that 1 base read this applicatim and rote also the ashore Informatim es
mrrca. 1 agree to camPIY with atl city sod county drdioan t,s and ruse lam .bring in
building construction, and hereby au0toriu representative of this city in enter upon th
shove-no,morred pmpeny for impaction purposes
(We) agree to cost, indemnifyMen and keep harmless the City of against s against
eapeosesrrit. may in any myacerm againstsaid City
in Imidex,jod.Ofthec.uand
of the granting of Nu permit.
A APPLICANT
APPLICANT UNDERSTAND AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOUR REG lGLS
"3� W
Re-roofs
-19"u. are Applican oC / ate
HAZARDOUS MATERIALS DISCLOSURE
Type Of Roof
Will the applicant or future building rampant pore. handle amsurial
u dcrrcd by lite Cupenimna Municipal Code. Chapter 9.13, and OHe
at Health arand Safety
ode.S Yes 25572(a)7
❑rem C-] No
All roofs shall be inspected prior to any roofing material being installed.
Will the i rant or future building are amuse
PP g P equipment m dMana video
If a roof is installed without first obtainingan inspection, I agree to remove
P gr
emit haaNnm air contaminants u defined by the Bay Area Air Quality Management
all new materials for inspection.
District?
El Y. 5K
I ban mail the hoomous maleriaesrquimmenu under Chapter6.95 of the Califor-
maHexlthASafclYCade, Sees. 25505,25533 an125534. Imai naaed thatifth building
ndlcurrently hil,c_laGt�/' a tenmet Nat Iyu as mdfy pompon) of the,
ofj
out oely
air rewh m ,ee\lmOethJ„�Vtaatt n01,7fKatearocmp /
o
Signature of Applicant Date
Utl v/n / l2/UES
�
All roof coverings to be Class'I "
g � or better
Owner or amhorircd ascot ' pfr �
•
•
4 ITEMS OF 4
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 32632041.01
DATE ISSUED.......: 06/12/2008
RECEIPT 4.........: BS000005093
REFERENCE ID # ...: 08060093
SITE ADDRESS .....: 10095 SAICH WY
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
143.61
---------------
143.61
VOICE ID DESCRIPTION
-------- ----------------------------
202 UNDERFLOOR PLUMBING
507 FINAL PLUMBING
REFERENCE NUMBER
--------------------
#1055
VOICE ID DESCRIPTION
-------- ----------------------------
ROUGH PLUMBING
OWNER ............:
MESSINA 1989 LIVING TRUST
ADDRESS ..........:
10095 SAICH
WAY
CITY/STATE/ZIP ...:
CUPERTINO,
CA 95014
RECEIVED FROM ....:
DONE -RIGHT
ROOTER
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
1BSEISMICO
----------
VALUATION 3,807.00
----------
0.84
----------
0.00
--------------------
0.84
0.00
1PGASCOM
OUTLETS 1.00
61.19
0.00
61.19
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
----------
143.61
----------
0.00
---------- ----------
143.61
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
143.61
---------------
143.61
VOICE ID DESCRIPTION
-------- ----------------------------
202 UNDERFLOOR PLUMBING
507 FINAL PLUMBING
REFERENCE NUMBER
--------------------
#1055
VOICE ID DESCRIPTION
-------- ----------------------------
ROUGH PLUMBING
•5(
CITY OF CUPEf�TINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
PERMIT APPLICATION FORM
06Foo o U 93
APN # { Z r / / U
Date:
2, -
Building Address: ��� S Q _ /
WI w 6( y
lov4S
Owner's Name: n,42'sSi j�1"njc 7? -VS 7—
Phone #: S ��47C10
Contractor: D.NL,_ �o� 9 h t �orYt�� ati� ���h �h5
Phone #:
Fax #:
Contact: f;&-p—r 7)e/ o
Phone #: jel� 4-62
Fax#: 3Z- /Z
Contractor License #: C -3(o C%Ubl2�o
Cupertino Business License #:
Job Description:
Residential ❑ Commercial �—
Valuation: 2
1 0 v-7 46L
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.
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PCSEWER
Commercial building
sewer/sanitary sewer
P
1CPSS
1BPREPIPE
Commercial re -pipe per fixture
P
1CPRP
/
1PGASCOM
Commercial Gas Piping System
1-4 Outlets
P
//��
4tw
IBSEISMICOM
Seismic Commercial
P
1BSEISMICR
Seismic Residential
P
1PRSEWER
Residential building
sewer/sanitary sewer
P
1RPSS
CITY of
CUPEkTINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
FEESCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PRREPIPE
Residential re -pipe per fixture
P
1RPRP
IBPWSVCS
Water Service
P
1CPWS or
1RPWS
1 PPRSEWG
Private Sewage Disposal System
P
1 PCESS
Cesspool
P
1BPWATER
Install/alter Water Pipe
P
1BPFIXTURE
Plumbing Fixture
P
1PGASRES
Residential Gas Piping System
1-4 Outlets
P
1 BPGAS
Gas Piping System 5+ Outlets
P
'
1PPERMITFEE
Plumbing Permit Fee Issuance
P
IPLMBLNCK
Plumbing Plan Check
P
IPLMBINSP
Other Plumbing/gas Insp.
P
/
1TRAVDOC
Travel & Documentation Fee
B
1BUSLIC
Business License
B
•
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
y'
B.
Site
9.
Install H.E. Irrigation, (details/spec)'
L-1
11.
Permeable Paving,Note
L-1
C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
7points
D.
Structural
3.
Uses Wood 1-Joist, (See Spec.)
S-2
5.
Use Truss with heels, (detail)
S-2
6.
B. OSB Sheathing,detail
S-2
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 cint
P.
Other
1.
List Green Features on Plans
A-1
1 point
MINIMM
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.
1. Recycle Job Site Construction &Demolition Waste
-
65%=1 point; 75%= 2 points; 80%= 4 points
up to 4 Resource
2. Salvage Reusable Building Materials
4 Resource pts y=
3. Remodel for Mixed Use, Adaptive Reuse, and
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 Slormwater Practices
2 Resource pts y=
7. Protect Water Quality with Landscape Design
2 Resource pts y=
8. Design Resource -Efficient Landscapes and Gardens
4 Resource pts y=
9. Reuse Materials/Use Recycled Content Materials
2 Resource pts
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
-
FI —Substitute
eSolid Sawn Lumber with Engineered Lumber
3 Resource pts
y=yes
2. Use FSC Certified Wood for iraming
(For every 10% of FSC lumber used = 2 points, up to 10)
up to 10 Resource pts.
3. Use Wood I -Joists for Floors and Ceilings
2 Resource pts
y=yes
4. Use Web Floor Trusses
2 Resource pts
y=yes
5. Design Energy Heels on Trusses 6' or more
2 Energy pts
y=yes
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts
y=yes
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=yes
8. 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
1 Resource pt
y=yes
j b. Sheathing ___ 1
•
1 Resource pt
y=yes
------------- ------i
1. Use Sustainable Decking Materials
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
Conservation Features
(1 point each, up to 3 points)
a. Recycled content
3 Resource pts
y=yes
0
4 Energy pts y=yes
7. Install Water Filtration Units at Faucets
1 b. FSC Certified Wood
3 Resource pts
y --yes
0
2. Use Treated Wood That Does Not Contain Chromium/Arsenic
1 IAQ/Health pt
y=yes
0
3. Install House Wrap under Siding I
1 IAQ/Health pt
y=yes
0
14. Use Fiber -Cement Siding Materials
1 Resource pt
y=yes
0
E. Plumbing
1. Install Water Heater Jacket 1 Energy pt
2. Insulate Hot and Cold Water Pipes 2 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 Toilest with Ultra -Low Flush Toilets
Conservation Features
(1 point each, up to 3 points)
Up to 3 Resource pts.
5. Install Chlorine Filter on Showerhead
1 IAQ/Health pt y=yes
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. tiecvmcai
1. Install Compact Fluorescent Light Bulbs (CFLs)
(6 bulbs=2 points, 10 bulbs =3 points, 12 bulbs = 4 points) Up to 4 Energy pts. 0 •
2. Install IC -AT Recessed Fixtures with CFLs (1 point each, up to
5 points) Up to 5 Energy pts. 0
3. Install Lighting Controls (1 point per fixture, up to 4 points) Up to 4 Energy pts. 0
4. Install High Efficiency Ceiling Fans with CFLs
(1 point each, up to 4 points) Up to 4 Energy pts. I L0
G. Appliances
1 Energy pt
1. Install Energy Star Dishwasher
2. Install Washing Machine with Water and Energy
Conservation Features
1 Energy pt
3.Install Energy Star Refrigerator
1 Energy pt
4. Install Built -In Recycling Center
3 Resource
H. Insulation
1. Upgrade Insulation to Exceed Title 24 Requirements
a. Walls 2 Energy pts y=yes
b. Ceilings 2 Energy pts y=yes
2. Install Floor Insulation over Crawl Space 4 Energy pts y=yes
3. Install Recycled -Content, Fiberglass Insulation w th
No Added Formaldehyde 3 IAO/Health pts y=yes
4. Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes
5. Use Cellulose Insulation
a. Walls 4 Resource pts y=yes
b. Ceilings 4 Resource pts y=yes
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls 4 Resource pts y=yes
D. ueilings 4 Resource pts y=yes
•
0
0
0
0
0
0
0
0
0
•
Fa.
1lnstall Eney-EfficientWindows Double -Paned 1 Energy pt
b. Low -Emissivity (Low -E) 2 Energy pts
c. Low. Conductivity Frames _ ! 2 Energy pts
2. Install Low Heat Transmission Glazing 1 Energy pt
J. Heating Ventilation and Air Conditioning
11. Use Duct Mastic on All Duct Joints
2 Energy pts
y=yes
2. Install Ductwork within Conditioned Space
3 Energy pts
y=yes
3. Vent Range Hood to the Outside
1 IAQ/Health pt
y=yes
4. Clean all Ducts Before Occupancy
2 IAQ/Health pts
y=yes
5. Install Solar Attic Fan
2 Energy pis
y=yes
6. Install Attic Ventilation Systems
1 Energy pt
y=yes
7. Install Whole House Fan
4 Energy pts
y=yes
8. Install Sealed Combustion Units
5 IAQ/Health pts
y=yes
a. Furnaces
3 IAQ/Health pts
y=yes
b. Water Heaters
31AQ/Health pts
y=yes
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps
3 Energy pts
y=yes
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
y=yes
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
y=yes
12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
y=yes
• 13. Retrofit Wood Burning Fireplaces
4 Energy pts
y=yes
a. Install EPA certified wood stovesMserts
1 IAQ/Health of
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
41AQ/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
V=Ves
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, 2A kw = 12 points, 3.6 kw =18 points)
Up to 18 Energy pts
6. Select Safe and Durable Roofing Materials —
1 Resource pt
y=yes
7. Install Radiant Barrer
3 Energy pts
y=yes
L. Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts
0
F1. flee LowMo-VOC Paint 1 IAQMeaith pts y=yes
----—---- ---------J
2. Use Low VOC,— Water -Based— Wood Finishes 21AQ/Heallh pts y=yes
3. Use LowMo VOC Adhesives 3 IAQ/Health pts y=yes
4. Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes
5. Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes
6. Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pis y=yes
17. Seal all Exposed Particleboard or MDF _ - 4 IAQ/Health pts y=yes
B. Use FSC Certified Materials for Interior Finish 4 Resource pis y=yes
9. Use Finger -Jointed or Recycled -Content Trim 1 Resource pis y=yes
10. Install Whole House Vacuum System 31AQ/Health pts y=yes
D
0
0
1. Select FSC Certified Wood Flooring
D •
0
0
0
0
0
0
y=yes
2. Use Rapidly Renewable Flooring Materials
-1 4 Resource pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Resource pts
Eq
4. Install Natural Linoleum in Place of Vinyl
5 IAQ/Health pts
y=yes
5. Use Exposed Concrete as Finished Floor
N. Flooring
1. Select FSC Certified Wood Flooring
6 Resource pts
y=yes
2. Use Rapidly Renewable Flooring Materials
-1 4 Resource pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Resource pts
y=yes
4. Install Natural Linoleum in Place of Vinyl
5 IAQ/Health pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 Resource pts
y=ye=.
6. Install Recycled Content Carpet with Low VOCs
4 Resource pts
y=ye:
Total Points Available: 1401 1301 57
Total Points Project Received: 0 01 0 •
G:datalprogslgreenbuildngguidelineslremodelerslgmenpointsfina12.12.04protected.sls
i
k
0