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08040221 CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INk'ORMATI0IV ' PERMITNO. BmLglgcarpDRSFasHADYGROVE CT ECONOMY' PLUMBING 08040221 OW NbERL'S2NSASME: PERMTT ISSUE DATE ANSHUAM NAGUNAEI 861 HINCKLEY RD 04/30/2008 NE: (650) 697-5100 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMTr INFO BLDG ELECT PLUMB MECH uoa LICENSED CONTRACTOR'S DECLARATION u g1 hereby affirm that 1 am licensed under provis cm;of Chapter 9(mmmeneing Job Description with section 7")of Division 3ofthe Hudmea soul professors Code,and my license u SEWER LINE RPLCMNT FRM HSE TO PROP LINE v, in full forte and effect. j _ Liosna t.7 Iia.Y F Dam Conuauor y� ARCNrtECTS DECLARA N W U 1 understand my plans shall W used as Public records a. Licensed Pmftmi0m1 3 OWNER-BUILDER DECLARATION Zoo 1 nasoereby slR,m Net 1 I.S.exempt from the Contractor's antons o e:Any cense Law for Ne Zoo O following mason.(Section703 comeBuaimss and Pmrneduns Code:Any city or aunty S$ which rtq in a permit re eosw0.aia,improve,demmRdt.or repair any u structure _i y Price m ire i licensed p arts requires the thovist. Of forstwh Cmurarmis Licom signed mvanms < N,boisliansedpursuantmNegoriaionsafNeConuaetorsluens:law(Chapter 9 S Ft. FIDorArea Valuation ,5@ (cmurnamng with Secure 7f DB of Division 3 of the Bum.and Professums Code)car q- $4100 that bo uxe exempt therefrom and the hur alle la far dr s nsuption.My violation of Section 1051.5 by any applicant for a Permit subjects the applicwuo a civil penalty of .1 norm than fin hundred dollars($5M. 37541027 .A Number Occupancy Type Luownerk.the Waimacm.,amnotimended yees wiNvnges rsah,(ere.compeusinam will d0 thew..and the a,Cmussme,Licese Law offereosoutapply 10 a4,Business Required Inspections propand ertywim ns Code Tbo matherem.License law dose out apply lf,t owner is q p Won enYwyees,provided daveathhaprondwM doessuchwmkh himself., his Won employees,Wilding iprogor improvement wen impronmcntsartnot earf oraRerrd the If, however.Ne have th La Wpmntoem usatheiiinot Wear of comPletim.tboowner- . Wilder wip nave dm burdens of proving that k did not ladid or impmn for puryma of _ ❑1.as owner of the Property am exclusively contracting with licensed contactors in chase La the Project(Sec.load.owner of and Preproperty a ons Code:)The Com thereon. Ice- who law dose not such a an owner of uatme(s who seilea or Improves 0emoa,and. z)AN �T who contracts for such proKcu with a contnamor(s)licensed pursuant m use Contractors 0 Ism law. lam sem tunder See ,Ba PCfmthurtason Owne Data ' WORKER'S COMPENSATON DECLARATION I hereby afrtm under Ner ty of perjury one of the fallowing declarsoats: 1ham4ndwillmainuina Ce rir teofComenuoself-Insurefoawoftes Comwn- ' salon,as Provided for by Section 3100 a the labor Code,for Ne performance of the weals for which this permit is issued ❑1 have and will maintain Workers Compensulnn Insurance,as required by section 31(10 or the labor Code,for the pedo..f Ne work for which this permit is issues My Warkess Comp11ewdso oe buunntce carrier d Policy number are: Carrier. In'I'V LL1 YC YlriP Policy No.:L.0 CA 660 Z4 Mi-D CERTIFICA OTFEEXEMPTION FROM WORKERS• COMPENSATION INSURANCE (Thlaxetion need not In completed if ile permit Is forone hundred dollars(6100) or lea) I certify that in Ne performance of Ne work For which Nis Permit is issued,l+hail nm employ anype.in any mumerw as m hemmer white,in the Wohm'CmopetuWOn Laws of California Dam Applicant NOTICE TO APPLICANT:If.after making this Ccnircate of Exemption,you should became subject in the Worker's Compensation provisions of the labor Code,you most .,z forawith comply with such prnyWOM or this Permit shall be deemed remked. zt N CONSTRUCTION LENDING AGENCY [-. 1 knotty affirm Nat them is a comersednn lending agency for the performance of !Yi the amIn,which Nis Permit is imued(Sec.3091,Civ.C.) QLenders Name z Leaders Address U O 1 anify that 1 ban red this application and sum that the above let..titin is cmtsect.I agree m comply with all city and coumy adiwaes and mm laws halal.,m - ,..... O tSJ^ Wilding connotation,and hereby audoorice mprewnudves or Nu city m enter upon ft .bon-mentioned Property for inspection purposes F 4 (We)agree to an,indemnify and keep hantlan the City of Cupertino against y liabilities,Judgments.Cents and eapmsm which may in any way amue again,said City V z incmnsegmec or thegoommsofthin Permit. (A ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale %` ���lis SOURCE REGU{.ATIONs��/ ` � �� t!a�%9 Re-roofs Si o or AppoanwCon to Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicmt m future Wilding acupantstom ter handle hassstlous material as darned by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Calc,Section 25532(x)1 Dyes rdfNo All roofs shall be inspected prior to any roofing material being installed. Will Nc applinn,orlot..Wildingocmpant sox equipment a devices Mich If a roof is installed without first obtaining an inspection,I agree to remove ist ' s air contaminants ss defined by the Bay Am&Air Quality Management all new materials for inspection. ubm"ic4 �� 0y. tsj Nu I ham real the hvadaumateriaU roquimmmts undo,CTm ser6.95arthe Califor- -I-Fit-l"Sefuty Code,SOetions 25505,25533 and25534.1 understood tnsoifilc Wilding does not cu r ndy ban a tenant Ng It la my neapomibility m mufy the cups,or dm tequlmmem,whien tarYdL ssumcear.Ccnrrtamara o g Signature of Applicant Date own atNm� mdgtmO,te All roof coverings to be Class'n"or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # I Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37541027 .00 DATE ISSUED. . . . . . . : 04/30/2008 RECEIPT #. . . . . . . . . : BS000004629 REFERENCE ID # . . . : 08040221 SITE ADDRESS . . . . . : 6283 SHADYGROVE CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ANSHUAM NAGUNAEI ADDRESS . . . . . . . . . . : 6283 SHADYGROVE CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014 RECEIVED FROM . . . . : BERNARDO CRUZ CONTRACTOR . . . . . . . : DAN GRIFFIN LIC # 29238 COMPANY . . . . . . . . . . : ECONOMY PLUMBING ADDRESS . . . . . . . . . . : 861 HINCKLEY RD CITY/STATE/ZIP . . . : BURLINGAME, CA 94010 TELEPHONE . . . . . . . . : (650) 697-5100 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- lBSEISMICR VALUATION 4, 100. 00 0 .50 0. 00 0 .50 1PPERMITFE FLAT RATE 1. 00 40.79 0. 00 40 .79 0. 00 IPRSEWER UNITS 1. 00 20.40 0 . 00 20. 40 0. 00 1TRAVD0C 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 -. n SEWER/LATERAL 507 FINAL PLUMBING • CITY OF CUPERTINO x REPIPE/SEWER/MAIN SERVICE i CUPEkTINO PERMIT APPLICATION FORM APN # 3.76 r-( iC7 Date: — a� O o o Building Address: v S3 - Owner's Name: Phone#: 140 _ 6 � g 3 - 8 93 44. CA Contractor: Phone#: 6'50 - /oY 7 - 5100 - cov pw� i �U �b� v\ Fax #: Contact: d Q 1 j. l l��a Phone#: 1108- 5044. df-;7 448 - Fax#: Contractor License#: Cupertino Business License#: Job Description: r1--V(4Cemcnt r6m NOvsc { n rpPc�Y�, I ( he Residential ® Commercial El Valuation: 4/Ob '�� 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 Permit Type Group 1PCSEWER Commercial building P 1CPSS sewer/sanitary sewer 1BPREPIPE Commercial re-pipe per fixture P 1CPRP 1 PGASCOM Commercial Gas Piping System P 1-4 Outlets 1BSEISMICOM Seismic Commercial P 1BSEISMICR Seismic Residential P 1PRSEWER Residential building P 1RPSS / sewer/sanitary sewer . " CITY OF CUPERTINO IS 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 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1BPWATER Install/alter Water Pipe P IBPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets 1 BPGAS Gas Piping System 5+ Outlets P 1PPERMITFEE Plumbing Permit Fee Issuance P 1PLMBLNCK Plumbing Plan Check P • 1PLMBINSP Other Plumbing/gas Insp. P 1TRAVDOC Travel & Documentation Fee B 1 BUSLIC 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 M. v B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 7polnts 11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-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 K 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 X71 O 4��jf m O i • 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.Site I(1.Recycle Job Site Construction&Demolition Waste (65%=1 point;75%= 2 points;80%=4 points ! -up to 4 Resource pts 0 12.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 �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 Foundation/Slab before backfill 3 Energy pts y=yes[;;F D 1 C.Structural Frame 1 1 17.Substitute Solid Sawn Lumber with Engineered Lumber _-1 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]-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 D 7.Use Engineered Studs for Vertical Applications 2 Resource pts y--yes 0 S.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 D 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 'h2Wse0SB -- -- — a.Subfloors 1 Resource pt y=yes 0 • b.Sheathing 1Resource P t y=yes 0 L- 1 I D. xtenor Fims INPUT Resources Energy IA011-lealth h.Use Sustainable Decking Materials a.Recycled content 3 Resource pts y=yes 0 • J.FSC Certified Wood 3 Resource pts y=yes 0 2.Use Treated Wood That Does Not Contain Chromiurn/Arsenic 1 IAQ/Health pt y=yes 0 3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0 4 Use Fiber-Cement Siding Materials 1 Resource pty=yes 0 1 1 1 E.Plumbing 1.Install Water Heater Jacket 1 Energy pt y=yes 0 2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0 3.Retrofit all Faucets and Showerheads with Flow Reducers a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0 b.Showerheads(1 point each,up to 2 points) i Up to 2 Resource pts. 0 - 4.Replace Toilest with Ultra-Low Flush Toilets (1 point each,up to 3 points) Up to 3 Resource pts. 0 5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0 6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0 7.Install Water Filtration Units at Faucets (2 points each,up to 4 points) Up to 4 IAO/Health pts. 0 6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 1 1 1 r:neancai �nstall Co Impact Fluorescent Light Bulbs(CFCs) I � i(6 bulbs—_2 points,10 bulbs=3 points,12 bulbs=4 points) J 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. 0 1 1 1 G.Appliances 17.Install Energy Star Dishwasher 1 Energy pt y=yes 0 12.Install Washing Machine with Water and Energy Conservation Features 1 Energy pt y=yes 0 3.Install Energy Star Refrigerator 1 Energy pt y=yes 0 !4.Install Built-In Recycling Center I 3 Resource pts y=yes 0 H.Insulation 1.Upgrade Insulation to Exceed Title 24 Requirements a.Walls 2 Energy pts y=yes 0 b.Ceilings 2 Energy pts y=yes 0 2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0 13.Install Recycled-Contenl,Fiberglass Insulation with No Added Formaldehyde 31AQ/Health pts y=yes 0 4.Use Advanced Infiltration Reduction Practices 2 Energy pis y=yes 0 5,Use Cellulose Insulation a.Walls 4 Resource pts y=yes 0 b.Ceilings 4 Resource pts y=yes 0 • 6.Alternative Insulation Products(Cotton,spray-foam) a.Walls 4 Resource pts y=yes 0 D.uemngs 4 Resource pts y=yes 0 I.Windows INPUT Resources Energy IAQIH,.Ir. `1.Install Energy-Efficient Windows • I a.Double-Paned 1 Energy pt y=yes 0 b.Low-Emissivity(Low-E) 2 Energy pts y=yes L_ Y Frames 0 c.Low.Conductivity _ _ 2 Energy pts y=yes 0 2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0 1 1 1 J.Heating Ventilation and Air Conditioning 1.Use DUG-Mastic on All Duct JoJoints - J 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 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 3 IAQ/Health pts y=yes 0 b.Water Heaters 31AQ/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 stoves/inserts 1 IAQ/Health pt y=yes 0 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 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 y=yes 0 3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0 4.Install Photovoltaic(PV)System (12 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0 Select Sale and Durable Roofing Materials_ __ 1 Resource pt y=yes 0 7.Install Radiant Barrier 3 Energy pts y=yes 0 I 1 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 p 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0 1 1 1 • INPUT Resources Energy IAO/Health M. ndoor it Qua dy and Fmshes 1.Use Low/No-VOC Paint _ __ _ 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes _ _ _ _ _ 2 IAO/Health pts y=yes 0 • i3.Use Low%No VOC Adhesives 3 IAQ/HealthY=Y is es 0 ' — —— — P 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 i7.Seal all Exposed Particleboard or OF 41AQ/Health pis y=yes 0 6.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 1 1 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 6 Resource pts y=yes0 2.Ne Rapidly Renewable Flooring Materials _ 4 Resource pts y--yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 51AQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 Total Points A 1 1401 1301 57 Total Points Project Received: 01 01 0 • G:datarprogslgreenbuildngguidelineshemodelers/greenpdntsfinal2.12.04protected.xls any Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 *UPERTINO Building Department JOB ADDRESS: PERMIT # 283 - S1ko,,d rods C+ . OWNER'S NAME: h 1,t] wtck j n e-I PHONE # GENERAL CONTRACTOR: EC©no,Tt ) to - FAX #6 t5jq - 6-'17 I am not using any subcontractors: 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 Cono rvtm i n 6 5 Roofing Septic Tank Sheet Metal Sheet Rock Tile v0 /05 Owner/Contractor Signature Date