08090218 BUILDING DIVISION PERNIIT �C�N'TRtsiCTORINI''f},,RMATIabN ,
xr �
PERMR NO.
au'LglNp,t�{tDRs:STELLING RD BAY AREA REPIPES 08090218
NEWS NNACCME:SS PERhfff ISUEDATE
ROLNICK DAVID P 0 BOX 7462 09/30/2008
PHONE: SAN WARY NO. COWIROL NO.
(408) 371-5763
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
u o o LICENSED CONTRACTOR'S DECLARATION Job Description
1 Wreby.farm Wm 1 am ltmn ed muter provisions of Chapter 9(commencing p
wiNSector
70(IB)ofDivision3oflM1eBusinessland Profcssion,Code,andmyliccmcis RE—PIPE HSE & ADD WTR SVC W/COPPER
in fall
� force a .f _
4 Cl
Lic if
-FO Dale Contractor
RCHTTECTS DFCLARAn0W-1
< 1 understand my plans shall thousand u public rccrds
ZG t; Licensed Professional -
OWNER-BUILDER DECLARATION
1 Wtoby alarm the I sm exempt from the Contractor's License law for tad
a� E
00 following mann.(Section 7(D IS,Biomass sued Professore Code:Any city or county
121 which requima a permit to construct,alter,improv,demaluh.or repair my ouetum
Liy prior as its couance.mat tape.uc.pplicant fortieth permit to fileasigned stsremem
i< thatWislicensedpurauanttotheprovisimuofthatContractor'sUcemclaw(CMpter9 Sq.Ft. Floor Area Valuation
yt-$ (commencing with Section 7000)of Division 3ofthe Business and PmfcasinmCook)or $6000
33— that W u exempt dmrefrom and the basis for this alleged exemption.Any violation of
Section 7071.5 by any applicant for a pc nsit subjects the.pplicmt to a civil penalty of Number Occupancy Type
amt mom thin fin hundred dollars u500), 36624055 :°(• P Y YP
❑1,v owner of the ryapenY•m mY employee with wage u their sole Lvmpensstion,
will do the work,and shutrumum is not intended m.Awed for sale(Sec 7044,Business
and Professbn Cade:The Contrmmr's Liccom Law deet not apply as as .or or Required Inspections
propenywho buildsorimpmna thercn,and whodoessuhwork himselfar through his
own employees,provided that each impronmmts are not intended aroRee d forsake.If,
bowevm.the building or impmnmant is sold within orc year of completion.the came,
Wilder will ham the burden of proving that W did mat build or imprme for purpose of
❑1,u owrcr of the Property.w exelusnly contracting with licemcd contrsmon to
coatsms-t dm pmjem(Sec.7014.Busnen and Professions Cade:)The Contrmbh Li. _
cent Taw does not apply in an cher of property who builds or i npfaYCV BleRmt.and,
who contra as for such projects wish a contramor(s)Iiarmmed parsoam to the Contractor's
License law.
Iamuemptumder See ,B&PCfoshurtuom
suer Data
WORKER'S COMPENSATION DECLARATION -
i lrreby alarm under penalty of perjury orc of the following declamuana:
❑I ham and will maintain aCenifiwm ofConeent to self-insure far .Worker's Camper"
sation,as provided for by Section 3700 of the labor Code•for the performance of the
wok for which this permit u issued.
Joint,and will maiw
nn Wmixes Compensation Insurance,as required by Section
fthe Taw,Code.for she efarmarrceof the wort far which this Permit is issued '
My Wokek apemau Ino. carrier and Polley numbm
Carsv:P am M.L Paliq Na.: 7r' �Oa Z
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE .
(Thu soNm rush ret W completed if IW permit u foraue hundred dollus(3100)
or less)
I coairy shot In she perform.of the work far which this Permit is issued.I shall not
employ any pcnan in any manner sou te became subject to that Workcof Compemauon
Laws of California.One
Applicant
NODCE TO APPLICANT:If.after making this Certificate of Eaemption,you should
become object at the Waheri Compensation provisions of the Labor Code,you muni
.J aZ forthwith comply with each provisions or this permit mail W allocated rooked,
z O CONSTRUCTION LENDING AGENCY
I Washy aTRlm that Nem is a construction lending agency far the Performance of
iL' > dm work for which this permit b issued(See 3097,Co.C.)
Q Lender's Name
.n Z Lender's Address
U O I certify N.l I ham teal this applieuian and store that the aWn information u
D.P ConecL 1 ague in comply with all dry and coldly ardin.ncee and fixe laws totaling in
O U Wilding construction,and hereby mshmia repheaomuvu of this city to enter upon lad
r I,I aWn"menuanedproperty for inspection which ms
(We)agree to un,indemnify and Frep harmless dm City of Cupertino against
fn incaiueser';Of thecomwoM expemmmit. may us any wYaavue Against said City
(„),z Acomegacrnm of theg ng of shatD WIL
APPLICA ND WILL COMPLY WITH L N N-POINT Issued by: Date
SOUR TI
�� Re-roofs
Sign amVfontrfd rDem
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will she applicant or future building accupmt store or handle ha umfous material
defined by the Cupertino Muriel ode,Chapter 9.13.and the Heilth and Safety
.sauna 25532(.)7
❑Yea All roofs shall be inspected prior to any roofing material being installed.
o
Will she applumt or future Wilding occupant use equipment o devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit harar anus air contaminants as defined by tad Bay Area Air Quality Management all new materials for inspection.
District?
❑Yc fIIW�
I hall read the hvndoussmmatrials mauirements undcrCMp or 6.95 ofthe Caiifer"
his Health&Safety Code.Sass 505.25533 wood 25514.1 anderswd than iftm Wilding
does mat current he ahsbilitYto motfytcocupamtofthe
reyrim ar t iauarweara 'faamofolcuparmy. Signature of Applicant Date
Owner arauthamad.scm, D,m All roof coverings to be Class'%?..'or better
• CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: B1k: . Lot:
APN . . . . . . . . : 36624055 . 00
DATE ISSUED. . . . . . . : 09/30/2008
RECEIPT # . . . . . . . . . : BS000006240
REFERENCE ID # . . . : 08090218
SITE ADDRESS . . . . . : 1498 S STELLING RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ROLNICK DAVID
ADDRESS . . . . . . . . . . : 1498 S STELLING RD
CITY/STATE/ZIP CUPERTINO CA, . 95014-5206
RECEIVED FROM . . . . : BAY AREA REPIPES
CONTRACTOR . . . . . . . : JOHN SWANSON LIC # 23773
COMPANY . . . . . . . . . . : BAY AREA REPIPES
ADDRESS . . . . . . . . . . : P 0 BOX 7462
• CITY/STATE/ZIP SAN JOSE, CA 95150
TELEPHONE . (408) 371-5763
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---- ------------- -- ---------- ---------- ---------- ----------
1BPWSVCS WATER SERVICE 1 . 00 20 . 40 0 . 00 20 .40 0 . 00
1BSEISMICR VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 .0 . 00
1PRREPIPE NO OF FIXTURE 10 . 00 102 . 00 0 . 00 102 . 00 0 . 00
---------- ---------- --------- -----
TOTAL PERMIT 123 . 00 0 . 00 123 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 123 . 00 #4257
---------------
TOTAL RECEIPT 123 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
106 SEWER & WATER 301 ROUGH PLUMBING
507 FINAL PLUMBING
•
oFo 0C,2le
CITY OF CUPERTINO
• REPIPE/SEWER/MAIN SERVICE
CUPEi�TINO PERMIT APPLICATION FORM
APN # qo Dat
Building Address:l
i d
Owner's Name: Phone #:
v'
Contractor: Phone#:
Are0. P I Fax #:
Cont ct: Phone#:
Fax #:
Contractor License #: q3(o
Cupertino Business License#: 13 -7
Job DeriptioI
'e-fIPif, hDvt (, a�� �9 tP/_ C4 Vlt,�i W l Cc�PPcf
Residential Commercial ❑
Valuation:
Project Size: Express Standard Large 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 1CPS9
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
tP111RSEWER
SEISMICOM Seismic Commercial p
SEISMICR Seismic Residential p
Residential building P 1RPSS
sewer/sanitary sewer
G Q s CITY OF CUPERTINO
REPIPE/SEWERIMAIN SERVICECOF
•
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
Q
l 1BPWSVCS Water Service P 1CPWS or
1RPWS
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
1PLMBINSP Other Plumbing/gas Insp. P
ITRAVDOC Travel &Documentation Fee B
1BUSLIC Business License j 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 Refrierator, (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 Resouices Energy IA011-leafth
A.Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;B0%=4 points d 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
8 Design Resource-Effcienl Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse MatedalsNse 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
B.Foundation 1
• 1.Incorporate Recycled Fyash 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 —. 7 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 p
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
• I1.Use0S8 — --- - — -- -- - l
a.Subficors 1 Resource pt y=yes 0
b.Sheathing
L t Resource pt )'=yes D
1 1 1
INPUT ResDunces Energy [AD/Health
D.Extenor Finish •
1 1.Use Sustainable Decking Materials
a.Recycled content 3.Resource pts y--yes 0
It,FSC Certified Wood 3 Resource pts y=yes 0
12.Use Treated Wood That Does Not Contain Chromium/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 t 1 Resource pt y=yes 0
E.Plumbing
1.Install Water Heater Jacket _ `_ _J 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 I
(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
S.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 IAQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.tiecmcai
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. 0
1 1 1
G.Appliances
1..Install Energy§tarDishwasher — 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy t
Conservation Features 1 Energy pt y=yes 0
3.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 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
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde — j 31AQ/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
D.uenings 4 Resource pts y=yes 0
1 1 1
• 1.Windows
FI _ Wi
.Install ins -Effcient ndow-s
a.Double-Paned 1 Energy pt y=yes LO b.Low-Emissivity(Low-E) 2 Energy pts y=yesc.Low.Conductivi FramesL__ _ _ 2 Energy pts y=yes 2.Install Low Heat Transmission Glazing - 1 Energy pt y=yes
1 1 1
J.Heating Ventilation and Air Conditioning
(t.Use Duct Mastic on All Dud 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 IAOMeallh pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes p
6,Install Attic Ventilation Systems 1 Energy pt . y=yes p
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes 0
b.Water Heaters 31AQ/Health pts y=yes p
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wal)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 p
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes p
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes p
13.Retrofit Wood Burning Fireplaces
a.Install EPA certifed wood stovesfnserts 1 IAQ/Health pt y=yes p
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 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 3 IAQ/Health pts y=yes p
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes p
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 p
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 16 Eneroy pts p
r' ____._. _ . ' - " _'�
6.Select Safe and Durable Roofn Materials
L___- _�._ __..__ A __ _ _ _ ___ _� 1 Resource pt y=yes p
7.Install Radiant Barrier 3 Energy pts y=yes p
1
L.Natural Heating and Cooling 1 1
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 p
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
• 1 1 1
INPUT ResDumes Energy IADIHmlth
-Kindoor Air Quality and Finishes •
F1.Use LLowMo-VOC Paint __ 1 IAQ/HealthY=Y
is es D
P
2.Use Low VOC,Water-Based Wood Finishes 2 IAO/Health pts y=yes 0
Use LowNo VOC Adhesives — — 31AO/Health pts y-yes 0
Z.Use Salvaged Materials for Interior Finishes 3 Resource pts yryes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AD Hsalth pis y=yes D
6.Use Exterior Grade Plywood for Interior Uses 1 IAD/Health pts y=yes 0
7 Seal all Exposed Pa ticleboa d or MDF
Po _ 41ADMealth pts y yesD
B.Use FSC Cefified Materials for Interior Finish J 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts, y--yes 0
1.
10.Install Whole House Vacuum System 3 IAO/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B 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 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 14 Resource pts y--yes 0
S.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0
1 i 1
Total Points 1 1401 130 57
Total Points Project Received: 1 01 01 0
G'.datarprogsigreenbuildingguidelineshemodelemigreenpointsfina12.12.04proteded.:ls
•