08030074 •
CITY OF CUPERTINO t w:.a 3'� >'
BUILDING DIVISION PERMITCQNtR*CTOE19k' ;;I
�ORMATION
k. •'.Tor`t,. k 1.wr 53z ,T3' 'za'pt. :1 ^.?
eull.gl�cgfeEsHELLY DR FOREST BUILDING 0803gg
0074
OWNER'S •
NAME; CONS 1 RUC 1 ION PERMIT(BUB DATA
ilkHOJEAN C AND GILBERT D PO BOX 183 03/14/2008
NE: SANITARY NO. CONTROL NO.
(650) 862-0742
ARCHITECT/ENGINEER: . BUILDING PERMIT INFO .
BLDG• ELECT PLUMB 0
3ee00 LICENSED CONTRACTORS DECLARATION Job Description
e4 withsectiatlo..).,Divirio^a3oiwBuneuraedPmf�nsCopderandmylienxu RMODL MSTR BTHRMRPLC EXSTNG SHWR MDL/TOILT/WNDOW
;4 N in full forte and effect.
9 z I.cense Clam Lie.g '
"o DateaContractor
ss ARCHITECT'S DECLARATION
L I understand my plans shall he used as public records
s u� Licensed Professional •
SN OWNER-BUILDER DECLARATION
''i I hereby affirm that I am exempt from the Contractor's License Law for the
Mg following reason.(Section 7131.5,Business and Professions Cale:Any city or county •
9 M which requires a permit to construct.alter.improve.demolish,or repair any smuctum
Z�, prior to its issuance,also n uima the applicant for such permit to file a signed statement
,SF< that he is licensed pursuant to thepmvisionsofthe Connector'License Law(Chapter? Sq.Ft. Floor Area Valuation
0 (commencing with Section d—• that he is exempt therefrom rand)the bash for the alleged exemption.AnyProfessions of Division 3 of the Business and violaden $8000
O
of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy▪ more than five hundred dollars($300). 35911021 . Pane y TYPe
❑I,as owner of the pmperry,or my employees with wages as their sole compensation.
will do the work.and thestructure is not intended or offered for sed(Sec.7044,Business Required Inspections
and Professions Code:Ilse Contractor's License Law dam tot apply to N owner of Q p
property who builds or improves Neeon,and who does such wart himself or through his
own employers.provided that such Improvements are not Intended or offered for sale If,
however,the building or improvement is sold within one year of completion,the owner.
builder win have the burden of proving that he did not build or improve for purpose of iiiy
1.u owner of tic property.w exclusively contracting with licensed rmtuxtors tom• prosemen
Etnuuvm the project(Sec.70th.Business and Professions Code:)The Comrmors U.
• Law does vol apply e u owner of progeny who builds or improves thereon,and,
who contracts far such projects with acentra7ar(a)licensed pursuant to the Contractors
License Law.
❑I un exempt rylder 5e/q. 4 ,BA PC for this reason �J
Owns d!/� {� Das `�//4f/Ot E.
• WORI(kJ�'S COMPENSATION DECLARATION
1 hereby affirm wider penalty of peujnry one of the following declantiane
❑I ham and will maintain a Certificate of Consent to self-Insure far Worker'eCampen-
nation.as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued. ..
❑I have and will maintain Winters Compenutlan Insurance,as required by Section
3703 of the Labor Code.for the performance of the work for which this permit is issued. .
My Worker's Compensation Insurance carrier and Policy number are:
•
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Oils section reed not be completed Mix permit is forme hundred dollen(8100)
or lea) ,
I certify that in the performance of the work for which this permit is Issued,I shall not
employ any person in any manner,mutobecome subjectto the,Wafke 'Campeau,..•
Laws yfntlHomin.Das yffeWo //
Applicant / ' te AlA/(y .
NOTICE TO APPLICANT:If,after making this Cem ate of Exemption.you should
become subject to the Workers Compensation provisions of the Labor Code,you must
,J Z forthwith comply with such provisions or this permit shall be deemed revoked.
ti CONSTRUCTION LENDING AGENCY
(~ I hereby affirm that there is a construction tending agency for the performance of
N,•.r the work for which this pennit is issued(Sec.3097,Cir.C.)
W G Landes Name
z Lender's Address. '
U OF I certify that I have read this application and tote Nu the above infmmadun is
ty' correct.I agree to comply with all city and county ordinances and hate laws relating to
C building construction.and hereby authorise representatives of this city to enter upon the
L31 above-menaned property for inspection purposes.
4 (We)agree l0 save,indcmerry and Fcep harmless the City of Cupertino against
I.y hal liabilities,judgments,cols and espensu which may In try way accrue against said City illi
���---'''fff
✓ inconsequencetheRng SthhpJIt, y . ! , 7 -9
,--
SOURCE
APPLICANT UNDERSTANDS� fl� ILL COMPLY WITH ALL NON-POINT Issued b �� V . Date
SOURCE REG ITONS C
/ -_ -- d/ /4 /10: r
rJ Re-roofs dOW
Signature or Applican_ Date
Oeb MATERIALS DISCLOSURE Type of Roof
Will the the Cupertino
or future buildingpalo occupant store or and handle hazardous material ••
as defined by Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(3)7 All roofs shall be inspected prior to any roofing material being installed.
ill '❑Ycs riTNo
Will the appiicul or future building occupant use equipment or deviw which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Ama Air Quality Management all new materials for inspection.
District? pp````��JJ////
❑YcosNu
•
I have real the huaNs\amaterialsrequirements under Cbapur 6.95 of the Califer.
Ma Health dr SarmyCode Sections 23505.25533 and 25534.1 undersand thailthe building
dims not cunenty have a tenant.that It is my responsibility to notify the occupant of the
requirements which nen tomes prior to issuance of a Certificate of Occupancy. Signature of Applicant Date
Jr/%L ;/ /t4 .340•� All roof coverings to be Class'%¢ or better
Owner or athagent Dam'
•
• CITY OF CUPERTINO
3 ITEMS OF 3 •
PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rug: Sub: Blk: Lot:
APN • 35911021.00
DATE ISSUED • 03/14/2008
RECEIPT # • BS000004158
REFERENCE ID # . . . : 08030074
SITE ADDRESS • 20619 SHELLY DR
SUBDIVISION
CITY • CUPERTINO
IMPACT AREA
OWNER • HO JEAN C AND GILBERT D
ADDRESS • 20619 SHELLY DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2923
RECEIVED FROM • HUNG CHEN
CONTRACTOR • LAM CHAN LIC # 29890
COMPANY • FOREST BUILDING CONSTRUCTION
ADDRESS • PO BOX 183
CITY/STATE/ZIP . . . : RIO NIDO, CA 95471
TELEPHONE • (650) 862-0742
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
1BSEISMICR VALUATION 8, 000. 00 0 .80 0. 00 0. 80 0. 00
1REMRESBAT SQ FEET 38. 00 429 .00 0. 00 429 . 00 0. 00
1STPLNCK HOURS 1. 00 122 . 00 0. 00 122 . 00 0. 00
TOTAL PERMIT : 551 . 80 0. 00 551 .80 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CREDIT CARD 551. 80 VISA
TOTAL RECEIPT : 551. 80
o ?o-S 0074
CITY OF CUPERTINO
•
G— ADDITION/REMODEL
CUPERJINO PERMIT APPLICATION FORM
APN# Date:
- / l- o / ,. po z' / / 4 / 2pog
Building Address:
6 / 9 cH&ccs/ o'e , cc%r`cIeT/ /U c
Mailing Address (if different from building address):
Owner's Name: J Phone# :
/-/ o 44, 0 b''- /l-.L6- /g/O
Contractor: Phone#:
Laiti, C1
For. rt ad ; 1 0(i r�� C' oks�l-uc:to�,Fax #:
Contractor License #:
Cupertino Business License#: '6 qv
Contact: Phone#: ds-_ /
I-J G( ti Cp C/-1 E/)
Fax #:
Building Permit Info: f l - 9 10.,.‘2_,,,, ,ic Nn un-_ v.&-mac
Bldg. Elect. V Plumb. [ Mech. Hillside ❑
Sob Description:
Addition (adding sq footage): , n t' e
What is being remodeled? //Cysto Y^ (Z e,f4 1 oo Ih
1l'--y a c-e s S/iDl, f k i'r& oc/"/e / f o ; (et/cs'r,47L
Remodel Includes Re-Roof: Yes ❑ No Eg If yes list number of squares
Remodel Includes Structural: Yes ❑ No a
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
tit
Remodel: Kitchen Bath 3g Other
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11FR ❑ 11, 111, V-1HR ❑ 11, 111, 1V V-N ft— 9
Valuation: Y Please check this box if the project is a
010 second-story addition ❑
Green Building Clleck list must be completed and
Ottached to the plans. Green Building Points Achieved: d�
***For Office Use Only***
Over-the-Counter ❑
CITY OF CUPERTINO
ADDITION/REMODEL
CUPEILTINO FEE SCHEDULE •
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
ADDITIONS 1R3SFDADD
PLLONGRNGR Long Range PL
Planning/Residential
1R3INSP Dwellings Inspections B
1R3PLNCK Dwellings plan check B
1R3REPINSP Dwellings Repeat B
Inspection
1R3REPPLNC Dwellings Repeat Plan B
Check
1R3HINSP Dwellings Hillside B
inspection
1R3HPLNCK Dwellings Hillside plan B
check
1R3HREINSP Dwellings Hillside B
Repeat Inspection
•
1R3HREPLNC Dwellings Hillside B
Repeat Plan Check
1R3ALTINSP Dwellings Alternate B
Materials Inspection
1R3ALTPLNC Dwellings Alternate B
Materials Plan Check
1PCESS Cesspool P
1PPRSEWG Ea. Private Sewage P
Disposal System
1PRSEWER Sewers P
1BPSPRINK Lawn Sprinkler/Backflow P
1BPWSVCS Main Water Service P
1BSEISMICRE SeismicResidential B
DECKS 1R3SFDADD OR
IR3SFDREM
1DECKWOOD Deck (Wood)-Each B
(Each)
•
1DECKRAIL Deck Railing-Each B
(Each)
CITY OF CUPERTINO
ADDITON/REMODEL
• FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
GARAGES 1R3SFDADD OR
1R3SFDREM
1GARDTW<=1K Wood Frame up to B
1,000 SF
1GARDTM<=1K Masonry up to 1,000 SF B
BCONSTAXR Construction Tax Res
(new detached garage)
PATIO'S OPEN 1R3SFDADD OR
1R3SFDREM
1PATIOWOOD Wood Frame up to 300 B
SF
1PATIOMETAL Metal Frame up to 300 B
SF
1PATIOOTHER Other Frame up to 300 SF B
PATIO'S CLOSED 1R3SFDADD OR
1R3SFDREM
•
1PATIOENCLW Enclosed Wood up to 300 B
SF
1PATIOENCLM Enclosed Metal up to 300 B
SF
1PATIOENCLO Other Enclosed Patio up B
to 300 SF
ICOVPORCH Porch Covered-Each B
(Each)
1REROOFRES Residential Re-roof Each B
100 SF
REMODELS 1R3SFDREM
1REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan
300 SF check)
3 c v 1REMRESBAT Bath Remodel up to 300 B «
SF
1REMREOTH Other Remodel up to 300 B ff
SF
REMODEL PLNCK
• ! 1 STPLNCK(1-3 for Standard Plan Check B NOT FOR OVER THE
remodel) COUNTER PLAN CKS.
3 of 3
CITY OF CUPERTINO
ADDITON/REMODEL
FEE SCHEDULE •
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
WINDOW/SLIDING 1R3SFDREM
GLASS DOOR
1 WINREP Replacement windows B
_(ea 8 windows)
1WINNEWNSTR New Window (non- B
structural)
1 WINMEWSTR New Window (Structural B
Shear Wall/Masonry)
1 WINBAYSTR Bay Window (Structural) B
SKYLIGHTS 1R3SFDREM
1 SKYL<10 SF Skylight less than 10 sf B
1SKYL>1OSF Skylight greater than 10 B
sf or structural
(STAIRS Stairs-first flight/ea addt'l B
•
1EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1ELCPLNCK Stand Alone Electric Pln E
Ck (hourly)
1MECPLNCK Stand Alone Mechanical M
Pin Ck (hourly
1PLMPLNCK Stand Alone Plumbing P
Pln Ck (hourly)
1BSEISMICRE Seismic Residential B
1TRAVDOC Travel &Documentation B
•
I BUSLIC Business License B
4 of 3
•
• _s--,,. „,,- Loa- k FIJNAL APPROVED
ei
5061 r-e-r.ir 4 'A v�.u.n — S'r,u-i.A e.4-•cet
YC7 2:1-CURE SIGURE
NATURE
DATE a/ /ru / zi) 67
•
Note: Electrical shows existing locations.
Q Incandescent Vanity light to connect to motion sensor.
4.k Light for fan is fluorescent.No motion sensor connection. ) ` •CZ
- 64 7/8" • ��
/69 ktc-7..) &pleb • 47--,..-, tst:0
A e-7.---" ‘ .
:..
• dV,,_i_ , --0i rt poe\ cfa
ni
-4,,,,
_,
The.
Q (,,ci _
tsk
Wl(2 ()to: cc s
S41 -0"
co
T t `
'v Fan/
r\ L Light A
Allis w
T1,--... -
T CO
N
U nNo r
re; 0'
i --i+ __ I —I yes 0 _�
POCKET DOOR
22 3/4" 16-0
• F 105 - 7/8"
•
• PLAN A midi....we desgnanons ®®®® Inn is anagitul Design atdttust not Designed:DllWg
gkenea cubjed toraibotmn en be released a copied unkssapplkobk Printed: tVNAO7
job sde end edjnsment to Al job D e, i x n Censer In ba been paid of Wider placed.
I cad'dons.
Toy00A- y/3eoT
DIFDFSCAIPDDX:DinsmtAtlnaiwalei IFP'. DRAWING di
• Sort_ of--- `"`r4-` FI AL APPROVED
rima cL-k ,ten �k `'r— ��c. K . tic"-
ROVEp SIGNATURE
jN ACCORDANCE WITH THE CITY 0 oi ( �� l Za D�
CUPERTINO CODES AND ORDINANCE: •
DATE
)ATE 3- (cc b
• 3IGNE�
of p ens ands
)e keptset on the '• specifications MUST n l//u(
lawfulphis to fah at alt eines and itis un
make any changes or alteration•
n same wlfhcuf w iyan
he bm.dm •
Permission IronCity of ._ i
he stamping of this
Cupertino.
;HALL NOT be p•an and specifications .. ktdrddri /
he;d to permit or to be
•
Note: Electrical shows exi4ti7Yg Idaatigns;;on of - an
Incandescent Vanity light td c6hneelntAc�gt g�neiff�iKkl�oa
VtLight for fan is fluorescent.No motion senso b taction.
4ct I- 64- 7/8" H
\ `
/&2ea) Psi
T \\T
VVV,,�t •
,
• d ,,,,\ : r\ pool Ht)
y �
�/ -,,..4-
...._
Mqy 1 g ��,
—r— —<O The). c.e & zoos
Q Wl ��'fs m
Y J 41 -0"
cc,
m
Fan/
in 1 . - Light A -
Z
',iii.)-. w
0\ V
N
J
U r
N In
_L S_ senior 0
J .7 Sensor
•
POCKET DOOR j
22- 3/4" X 16 - 0" .1
H
105 -7/8" •
PLANAAlldimnsiwsbwedengwmns ®®®® Ihrdunoriginal Desinand muslnot Designed:02/2107
idime subM1'slmrn'rfiwrionon beukaed o copied unkuappliuble Ponied: 01/07/07
job site and AWN lien to fir tib o e, i a n c e n r e . lee fins been paid od min placed.
maim. � D2
FIFIXSWPINX:amngllwaimArkti /7����A" �ry•,N/•O7
•
OWNER-BUILDER VERIFICATION
1. (Check one) I or my immediate family (parent, spouse or child) will perform:
• A. All the work authorized by this permit
B. K A portion of the work
C. None of the work
If B or C is checked, complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A. All of the work
B. x A portion of the work (complete section below)
Contractor Address/City Phone # State License # Type of work to
be performed
L/,w, C
I--otecf- aUi h.9
CO(.. (.7- c'fl2l.
• 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office.
Person/Firm Address/City Phone Number Type of work to be
performed
•
•
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Property Owner's Signature: (l �� , Date: S / l L/ / a o
'Job Address: 2 o 6 5' S'H -L t> ,Z Gu I' Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
410
Department.
ar •
.,
City of Cupertino Building Departments
CITY OF 10300 Torre Avenue
CUPEION0 Phone: (408)777-3228
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself, you
may protect yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work,with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work
(including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer,you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes, workers' compensation insurance,disability insurance costs, and unemployment compensation•
contributions.
There may be financial risks for you if you do not carry out these obligations,and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and, if you wish,the U.S. Small Business Administration). For more specific information about your
obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department, •
City of Cupertino
Printed on Recycled Paper
4 - •
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number: 5 `C y - / 1 - e
Name of owner. ,7 A A.' k C
Project address. .,- 0 (1_, f 7 S Het L Y 0 tc , c r-{ P e /: / / 4,1 v
Contact person. l7 Gti N Cr C lj 'lj Phone. L f S `7 { — /:i /9
Fax.
Net square footage of lot. 7.. -C0 C
Existing Proposed
Square footage: First floor:
Second floor: C /� •
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? N
Is privacy protection planting required for the project? Y N
On what floor(s) is work being done? / c t / kcJ° c-
Brief description of work. E7 k,; 01/1 i t n . dr•- I P c b-/-1
StOLJEt- th0dr,lf. 1
-7-' tt1f / Uriowi-) ii
Code editions:2007 CBC Q- N)2007 CFC 0-N)2007 CMC t N) J 111'
2007 CPC ®- N)2007 NEC & N)
kt
MAR 13 X609
Effective 1/1/08 APPROVED IN ACCORDANCE WITH THE CIT/ OE
CUPERTINO CODES AND ORDINANC
3,4 7-___________2(2 -
WE
� -
WE • 4/0
ecifications MUSS t
T eis sans and -P
This set of Phe lob at all times anylteraUnn• zzf"JJJ
% kept p0 , changes or ,f,
when P% ell iron, l
lawful to v without/
ma Dept., City of Cupe t ti
on ecrfication
• Th building plan and sP
The U. NOT bet this
d o paamit or to a
be �
violation of any provlslnn
;HALL NOT
,pproval of the nonce or star° l Pu'
�nvcirv �
COMMONLY MISSED PLAN CHECK ITEMS
Plan Review Process Work Book Page-8-Revised 1/1/08
SCOPE OF WORK APN: 359-11-021
INTERIOR ALTERATION ADDRESS: 20619 SHELLY DRIVE
CUPERTINO, CA 95014
MASTER BATHROOM DATE: MARCH 14, 2008
REMODEL
SHOWER MODULE / TOILET/ WINDOW
REPLACEMENT
a 115'4"/
14'41 4" i
•
SHOWER s M. BA. I
TEMP GL
O
ENCLOSURE ! W.I.C. a
FLUORSC:•• o
0 „/LIGHT
1.6 GAL. 1
MAX. "
PER FLUSH I GFI
w .
/
3030 411 14'6"1
GFI
A DEDICATED 20-AMP CIRCUIT TO SERVE THE REQ'D BATHROOM OUTLETS
ALL SWITCHES ARE TO BE OF THE GROUNDED TYPE AS PER CEC (380-9)
• • •
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 IAOIHealth
• Site ...
6 r . l�.Pr 3-{ 3 v
'1.Reeycle'Job Site Construction&Demolition Waste
'65% 1 point:75%= 2 poiht;'B0%=4"points Y-l`" " -• - up to 4 Resource pts D
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 Stonnwater Practices . 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes D
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
•
0 0 0
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 beckillt • 3 Energy pts y=yes 0
0 0 0
C.Structural Frame
1'.Substitute solid sawn Lumber with Engineered Lumber, 3 Resource pts • y=yes 0
2.Use FSC Certified Wood for framing
(F6r 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 D
.11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes ,0
12.Use OSB
• a.Subfloors1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0
0 0 0
INPUT Resources Energy Health
B. t' or In s
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y=yes- 0
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 1 IAD/Health pt y=yes- 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes _ • 0
0 0 0
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) 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 IAO/Health pl 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
U U U
r.tlecrrrcer
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 Gelling Fans with CFLs
(1 point each,up to 4 points) . Up to 4 Energy pts. 0
U U U
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes- 0
2.Install Washing Machine with Water and Energy •
Conservation Features 1 Energy pt y=yes 0
3.Install Energy Star Refriberator 1 Energy pt y=yes- 0
4.Install Built-In Recycling Center 3 Resource pts y=yes_ 0
U U U
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pis y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 3 IAO/Health pts y=yes 0
4. Use Advanced Infiltration Reduction Practices 2 Energy pts 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
o.ceitings 4 Resource pts y=yes 0
0 0 0
•
' INPUT Resources Energy IAD/Health
.tt m•ems
• 1.Install Energy-Efficient Windows
a.Double-Paned I 1 Energy pt yryes • . 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
' c.Low.Conductivity Frames 2 Energy pts y=yes . D
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
•
0 0 0
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 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan i 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 JAOMealth 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 Buming Fireplaces
•
a.Install EPA certified wood stoves/inserts 1 IAO/Health pt y=yes 0
.b. Install/Replace Dampers ' 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt yryes 0
14,Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 4 IAO/Health pts y=yes . 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAOMealth pts y=yes • 0
17.Install Separate Garage Exhaust Fan 3 IAO/Health pts yryes0
0 0 0
K.Renewable Energy and Roofing -
1 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 16 Energy pts0
6.Select Safe and Durable Roofing Materials 1 Resource pt yryes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
•
0 0 0
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 •
• • 0 0 0
•
•
INPUT Resources Energy IAD/Health
. n•oor flue Cyan• ns es
1.Use Low/No-VOC Paint 1 IAOMealth pts y=yes 0 41)
2.Use Low VOC,Water-Based Wood Finishes 2lAOMealth pts y=yes 0
3.US Low/No VOC Adhesives 3 IAO/Health pts y=yes 0
4.Use Salvaged Matedals for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea •
Formaldehyde S IAO/Health ptsy=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAOMealth pts y=yes 0
.7.Seal all Exposed Particleboard or MDF 4lAO/Health pts y=yes 0
B.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
10.Install Whole House Vacuum System 3 lAO/Health pts y=yes 0
0 0 0
It Flooring
1.Select FSC Certified Wood Flooring 6 Resource pts y=yes 0
2.Use 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 5 IAO/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
•
0 0 0
• Total Points Available: ( 1401 130! 571 fp
Total Points Project Received: ( Oj 01 • 0
• a:datarprogUgreenbulldnggddoDneslramodelersrgreenpohiWnal212o4protactedAs
•
RESIDENTIAL PROJECT COVER SHEET
Assessor's Parcel Number: `' 7— / / - C "
Name of owner. /��� / / cs
Project address.
0r �, ( S{� f_. t Y' Pt , C { Pf / MMJt'
Contact person. H L2 C /-/ G✓d Phone. CL 1 c /~ /"a t y
Fax.
Net square footage of lot. S 0 C
Existing Proposed
Square footage: First floor:
Second floor:
Ga
Garage: ..
TOTAL: -
Are there at least two 10 foot by 20 foot clear spaces inside the garage? "fes N
•
Is privacy protection planting required for the project? Y N
On what floor(s) is work being done? / S t Eh') 1'
Brief description of work. 1Ks. /RAH, kr) Oiy, ' Rcrr.adi,_ / ; <<-Lrjcc YtsF,'!,>
Si.°GJ P4- rho dr; IP / �, ;�il 'l / IJi kt)
Code editions: 2007 CBC N)2007 CFC N)2007 CMC )
2007 CPC 6- N)2007 NEC &N)
Effective 1/1/08
VIS" Aet‘
4)
4�
•
COMMONLY MISSED PLAN CHECK ITEMS
Plan Review Process Work Book Page-8-Revised 1/1/08
•
4 1
SCOPE OF WORK APN: 359-11-021
INTERIOR ALTERATION ADDRESS: 20619 SHELLY DRIVE
CUPERTINO, CA 95014
MASTER BATHROOM DATE: MARCH 14, 2008
REMODEL
SHOWER MODULE / TOILET/ WINDOW I
REPLACEMENT
a 115'4"/
1441 -a
I •
SHOWER 4 M. BA.
&TEMP GL
O
ENCLOSURE ! W.I.C.
FLUORSC:,, o
LIGHT
1.6 GAL. 1 ,
MAX.
PER FLUSH 4 GFI
3030 4_ 14 6 / i
GFI
A DEDICATED 20-AMP CIRCUIT TO SERVE THE REQ'D BATHROOM OUTLETS
ALL SWITCHES ARE TO BE OF THE GROUNDED TYPE AS PER CEC (380-9)
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
SUPEBJINO
Building Department
JOB ADDRESS:tipPERMIT
( 9 S I ^ Or
OWNER'S NAME: �CcJn C PHONE ‘±-0- &6 7.r O j C(
GENERAL CONTRACTOR: / 0,1 C kw\ FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
gi 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
•
/ / 147 20009
• .r Contractor Signature Date