08070230 CITY OF CUPERTINO ��a,a�
BUILDING DIVISION PERMITCffi" �'.,��y;�rION•,Ivy^.
BUI IN DORESS: PERMITNO.
SG2A SEPTEMBER DR TBD - TO BE DETERMINED 08070230
OWNER'S NAME: PERMTISUE DATE
131:;NJAMIN WU 07/31/2008
ryE: SANITARY NO. CONTROL NO.
ARCHITEC IENGINEEA: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
900 LICENSED CONTRACTOR'S DECLARATION
I thereby&from That 1 am licensed under provisiom of Chapter 9(commencing Job Description
with Sectio 7000)nfDivisha l ofine Bushossand Pwiesiuns Code,and my liana r INSTL PROPTY LINE CLEANOUT
u in full forte and effca
32- Lies.Clan
=p
Dam.Conuvoor
7W7W ARCHITECI•S DECLARATION
U I undersand my plans shall be used u public records
n
s u. Litt,tmd Professional
c[)5 OWNER-BUILDER DECLARATION t
1 hcrthy.(Seco that 1 1. cumpt from pte Conunat Co License Lew for 0e
p o following rtmom.(Saito 7 o Lr Business and e.de tins Cock:Any city m county
$�i which rtquims•permit m.i.tel aper.improv,demolish.I or a pair any ommusomeone,
-iy priorw irissumco,tlm rtquims teeapplicant for.tach Con panni'mimnsc Law(awmcm
< dr be encingwit pursuant
eason700)of Divionaaf theeBuumr'a Liconm Taw(C Code)or
Sq.Ft.Floor Area $ Valuation
E0 (commencing is commit Season the
actual for
the
the Budcomnsicm.ess and Any
Ctde)of 2000
Q Se t
Section
u campy thcrtfrom and the bur for the alleged a plicam .Any violation of
Section dere by eery red dlla far a permit subjects the applicant w s civil penalty of Number Occupancy Type
.at mom don Lite wnama dollars(ssDa). 3 6 214 014 .� p y YP
i]1,u owner of the property,a my wplaycm vied wages u Heir colt compewuon,
will do the wart,and de structure Is on,Intended or offered for sal IS=.7 .Business;
and Professions Cade:The Contrxnors License law does ant apply w an owner of Required Inspections
property who builds or improve;thermn,and who does such work hi m m il'of thmugh his
own employers.provided WI such improvements,rt not intended oroffemst forint.If,
however,the laulding or improvement Is mid within arc year of compleum.the owur-
builder will have the burden of proving than ha did our build or improv for purpose of
u
1,u owner of the property ser exclusively cont wring with licensed conuxws w
.meet the onjum(Sec.70ad,Business and Professions Cade:)rte 0muecwrs U. ,
cense Law docs not apply in an owner of property who buide or impmws themwn.and
who commis for such projects with a comactor(s)licensed pursuant w the Conuacwrs
License law.
❑Iam ext//qtg(R(qI under Sec B&P C for the moon
Owner I✓�i� `(/e✓ C. Zt'�
RKER'S COMPENSATION DECLAI IO
I hembir dntm under penalty of perjury one of the fallowing declanuou:
and will 1 haw all maimafn a Cetificam ofConant w self-imam for Wmter,Compen-
sation,as provided for by Section 3700 of the labor Code,for,the performance of the
work for which this Permit is issued. .
0 1 have and will m.InWn Water's Compensation Insurance,as required by Smuon
3700 o(ft labor Code.for the performance of the work for which this permit is issued. .
My Workers Compemadm lam um carrier and Policy mumps,an:
Cagier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This suction need rot he completed if the permit is formas hundred dollars(5100)
nr lens.)
I anify than in the performance of the work for which this Permit is issued,1[hall net
employ any perm.in my manor,w u tghe e'er{lett wfly Women'Compensation
Laws of Cali!0 ] du tS
Applicant f c..
NOTICE'FO AliPLICANT.If,after making this Cenincaw of Exemption,you should
become mbjut m the Worteh Compcnsrd..provisions of the labor Cadc you muss
.J z forthwith comply with such Provisions Or that Permit Nell be doomed cooked.
z O CONSTRUCTION LENDING AGENCY
.y., Ihemh alarm dust Nem iso comuuginn mdin
!Yi > the work for which thit , agency far the lerfmma,c of
Permit r toad(Ste.709'1,Civ.C.)
0. C1 leviers Name
n lenders Md.
0
U
(J Q 1 certify Nat I hoe reed this and county
and sum that the shove wsm fisting u
{f.
cement.1,grte w comply with all city and county oNinanom and sum Ian elating w
.Q bbow-becookonedogand for by immison umoscs. uvrs ofthrcity wcnwrupm the
W ahbvnmentitnedproperty forinspection p high b
F g), (We)agree w ave,indemnify and keep hanel ss the City of Cupertino a{.Inst
rq Ilebilitiu,Judgmenw.co[a and expcnam which may in any way acme against said City
V Z in consequence of the granting of this permis . S �I z
'-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date I> Z�
SOURCE REqPL6T1ONS. / /3// b
PL/_120 A Re-roofs
Signuurto Appli uConumar Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will 0te aPtiiant or to=building nempmtswm m handle h mardam¢mould
u Ached by the Cupertino Municipal Codc.Chapm,9.12,stud the Health and Safety
code.satien ss532(,)1 All roofs shall be inspected prior to any roofing material being installed.
oYm tiW
Will the applicant or future building occupant um'elpmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove
ti�ci7ardnus
all mr umimons
/defined by the Bay Arta Air Quality Management all new materials for inspection.
❑Yu QOu
I have mal the hvadmel mauriala mquimmenu under Cheptera.93 of theCalifor-
maHcalthkSafetyCede,Smunro 5X)5,25533 sm12553/.l undersand thatifNc Wilding
dons oat cumcmlY how a ten t.that it is my responsibility w madfy the occupant of the
mquimm/m�/�_.hig�m_mt—bc m�pdyym.wvm is cevirica5of�7ca "a.aur Signature of Applicant Date
Owner b,authan, agent Dow All roof coverings to be Class'R!'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . . 36214014 . 00
DATE ISSUED. . . . . . . : 07/31/2008
RECEIPT # . . . . . . . . . : BS000005641
REFERENCE ID # . . . : 08070230
SITE ADDRESS . . . . . : 882 SEPTEMBER DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. BENJAMIN WU
ADDRESS . . . . . . . . . . : 882 SEPTEMBER DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4127
RECEIVED FROM . . . . : BENJAMIN WU
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
1.BSEISMICR VALUATION 2, 000 . 00 0 . 50 0 . 00 0 . 50 0. 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0. 00
1.PRSEWER UNITS 1 . 00 20 .40 0 . 00 20 . 40 0 . 00
1.TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 102 .48 0 . 00 102 . 48 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 102 . 48 VISA
---------------
TOTAL RECEIPT 102 . 48
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
•
'2 a-\
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
• CUPEkTINO PERMIT APPLICATION FORM
APN# .� r � / C/0/L/- Lm Date: 7/:,' 1/-!," S-
Building
/y I -, " S-
BuildingAddress: g 7 S�Pev%hey 'DY. Clirey/-Ylv C/
Owner's Name: 4. E-451�N -LAV Phone#7- 276Y- Yo
Contractor: Q Phone #:
` O Fax #:
Contact: Phone #:
Fax #:
Contractor License#:
Cupertino Business License#:
Job Description: InSP� P,,vPe j �Ne cam.. okf,
Residential Commercial ❑
Valuation:. 412- k
Project Size: Express Standard ❑ Large 0 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 Fee ID Fee Description Fee Permit Type
Group
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial—
P
1BSEISMICR Seismic Residential P
r
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
` REPIPE/SEWER/MAIN SERVICE
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
JR-PWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
1PPERMITFEE Plumbing Permit Fee Issuance P
1PLMBLNCK Plumbing Plan Check P •
IPLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel &Documentation Fee B
'1BUSLIC Business License B
Revised 6-16-08
•
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 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 ooint
P. Other 1. List Green Features on Plans A-1 1 point
a 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.Srte INPUT ReSOUTCeS Energy A011-lealth
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;BOO/6=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 Slormwaler 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 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 Foundafion/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 I-Joists 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 •
• I. mows INPUT Resources Energy IAQ1Heai1g,..
1.Install Energy-Efficient Windows
• e.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 yryes 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 0
5.Install Solar Attic Fan 2 Energy pis 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
6.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQMealth 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 SEERM 1 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 stoveslnserts 1 IAQMealth pt y=yes 0
b. Instali/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 4IAQ/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 IAQMealth 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=1 B points) Up to 15 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
I I I
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 p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
1 1 1
•
Community Development
sm
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
*UPEkTINO
B ilding De artment
JOB ADDRESS: }}744;rW6tAS C . PERMIT #
</ 7 ,),i0 C �-O
OWNER'S NAME: P2:ZjV W PHONE # Z' ,
GENERAL CONTRACTOR: 'T FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following ' ormation:
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