08060150 CITY OF CUPERTINOcr-
BUILDING DIVISION PERMIT tCONTRAGTQR INFORMATION
PERMIT NO.
BUILpty,Tl 1't TEVENS CREEK BLVD ALL VALLEY PLUMBING 08060150
OWNER'S NAME: .S PERMIT ISSUE DATE
13ALL DAVID F AND ROSA 0 3345 SELDON CT 06/23./2008
NE: (510) 376-4816 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG EIF.CI' PMECH
0 0 0 0
3 o p LICENSED CONTRACTOR'S DECLARATION Job Description
boost, fr..Jul 1 am 1'unvcd umler proviuov of Chapter Y(mmmc=Ing
with SectiOn]DIMB Of Diviuon]af Ne Badness ane Profeuiav Code,and mylkenseu RMV & REPLC WTR HEATER
^ in full(me am cnW.
z Llcense Cl CL L" al ez
=F❑ Dow Contiuwr
n ARCHITECTSIECLARATION
ee I urldcrtoanJ my plan shall be used as public rc,mft
JyU
g Licensed ProfesuanaI
OWNER-BUILDER DECLARATION
I bcmby aRrm Nal i am exempt from the Conlucmfs License law far the
o C following
a moon.(Section 71171.5,Bunions;and Rofesuov Code:Any city or county
which mquims a permit m matrucL alcor,improve.dcmolub,ar repair any structure
Sri prior in its issue=c,also requires the applinnt for such Permit file a signed suumcm
p: Nu heulicensed pu usultmthcprovisionsoftheConJ•chRaLI=eA'Iaw(ChapLLT9 Sq.Ft. Floor Area Valuation
iH$ (commencing wide Soc.h.]0110)of Div¢ion 3 of Ne Business and Profession Code)or $350
e 5 i Nn he is exempt timmrrom and the basis for the alleged exemption.Any violation of
Section 7071.5 by arty applisat for a permit subjects the applicant in a civil penalty ofNumber Occupancy
=h mere then five hundred dolum Wave). 3 4 212 0 3 8 . P Y Type
0 1.0e ofthepropertymmywployttswishwagsaft4mleeomp don,
willdathewark.andthemumumisnotimmndesmaRemdfmsale(S .]ON,Bu moss Required Inspections
and Preload."Code:The Conuacure,License Law does not apply m e ns an owner of q p
property who builds a improve thereon.end wWd=ssueh wmthimsefror through his
own employes.provided that such imprmemem;tie not intended uroRered finale.It.
however.the building err improvement Is sold wibun oro year of emopleuou.the ow=r.
builder will have Use,burden of proving that he did nm hued or improve for Purpose of
ale.).
❑L an owrcs of the Property,am eaellouvely contraung with licerued cenuanan in
construct use pmfea(Sec.7066,Business and Professional Cade:)The Contractors U.
cove law dos not apply to an owner of propeny who builds or improv thereon,and
who contracts for such projeces with a contractur(s)Incomes pursuant m one,Contrutors
Llcemse law.
❑ltonucm�ptun�d ,B&PCfm Niamason
Owuar Date 06
WORKER'S COMPENSATION DECLARATION
40 I thereby aQ=under penalty of perjury o=of Ne fallowing declarations:
1 have and will mountain a Cenifiste of Covent m self-insure fm WorkersCompen-
seuon.as provided for by Section 3700 of the Labor Code,fm the Performance of Ne
wort for which Ws permit is wheat.
I have ad will maintain Workers Compensation I.W.,an required by Section
37[)().f Ne labor Code.for the perfomunc,wrthe wort roe which this permit is issued.
My Workers Compensation haysance carrier told Policy number K:
Cartier. Polity No.:
CERTIFICATE OF EKEMP ION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section recd not xeampleted if Oe permit is faro=hmuscdsollara($I00)
or lace)
1 certify that In the performance of the work for which this Permit is Wood.l shall nm
employ any person i.........m beonme subject ha Ne Wohers'Comperuation
Laws of Caliromia.Date
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
Wcome subject m the Workers Compensation provisions of Nc labor Cade,you moan
.,O foMwiN comply with such provision or this peanit shall be decreed revoked.
z v'-' CONSTRUCTION LENDING AGENCY
.�
[—i I Inclebywhip thi Nu there uacd(Sec.30 lending agency for the performance of
D: Nc work for which this permit u issued(See.709],Civ.C.)
Iz7 A Lenders Name
z Lariats Address
V Q I unify that 1 have read Nis application ass sure this tic above information is;
IL ^. currents-1 agree m comply with all city and county costumes and sou laws relating to
0 SVS building construction.and hereby aubbotim representatives of this city to toter upon the
0. shove-mcnuoneddgm property for inspection which may
(We)agree m save,indemnify and keep harmless the City of Cupertino against
h In cmus,ludgmc the, u e,spcas mit. may in ay soy amuc against City
U z APPLICANTT UNDERSTANDS ANof this D WILL COMPLY WITH ALL NON-POINT Issued by: Dale
SOURC I
[]G 237hff—
Signature er Applicacmr ' U• Re-roofs
HAZARAZ&RDOUS MATERIALS DISCLOSURE Type of Roof
Wlil the a Cupent of future building occupant.Chpa 9rc or handle hanrdounmaterial
u dentes io the Cupertino Municipal Code.Chapter 9.15,as Ne Health and Safety
Code.section sssJz(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Y Biro
Will the applicant or future building occupam use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it haraNnv air communion as defined by the Bay Area Air Quality Management all new materials for inspection.
D solea
❑Yen 11;�qsa
I have mal the haalloa materials requirements underChapo x6.95 ofd=Califon
nice Health&Safety Cade.Sermon 25505.]5533 am125534.1 undenund Nu if the,building
Jean=t cuncn0y have a ruts=that it u my msivalwhility m=ufy tic o=upmt of the
ncticnts whk e
ed agent Date gl prior m issuance of a ceniflcaw of Occupancy. Signature of Applicant Date
ob�Z3/OS All roof coverings to be Class'"or better
Owner or coo ant
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 34212038 . 00
DATE ISSUED. . . . . . . : 06/23/2008
RECEIPT # . . . . . . . . . : BS000005183
REFERENCE ID # . . . : 08060150
SITE ADDRESS . . . . . : 22639 STEVENS CREEK BLVD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BALL DAVID F AND ROSA 0
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5625
RECEIVED FROM . . . . : ALL VALLEY PLUMBING
CONTRACTOR . . . . . . . : MARY SANDBRINK LIC # 23015
COMPANY . . . . . . . . . . : ALL VALLEY PLUMBING
ADDRESS . . . . . . . . . . : 3345 SELDON CT
CITY/STATE/ZIP . . . : FREMONT, CA 94539
TELEPHONE . . . . . . . . : (510) 376-4816
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- - --- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 350 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 .48 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 106 . 56 #1358
---------------
TOTAL RECEIPT 106. 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
---- ---------------------------
-------- ----------------------------
518 WATER HEATER
•
CITY OF CUPERTINO
WATER BEATER
CUPEF,TINO PER-MIT APPLICATION FORM
Date,
A
B,,ifldincJ Address:
N-d Phone -z:
on taC7ot.
Fax --I' :
-
c*uT-,)erijn, Business License Contrac. State !Jcen.;
%-.ontaci:
Dyz/ Fax T-: Z;
—---------
B'lfldin'a peIil inf'():
B d 7 E 1 Phunb 1
oninler-cial
Job Descnpiu)n.
Qz
t r at)p ed. L -'M v' Bonded t New Locati . n Repjacem,nt
cy�
I V alu?".Inn-
GreeD Building Check must be completed and attached to this application.
• Green Building Points achieved:
CITY OF CUPERTINO
Iza-- WATER HEATER
4fUPEkTiNO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
Heater/Vent
1BSEISMICOM Seismic Commercial B
1PRWHEATR Residential Water B PRWHEATR
HeaterNent
1BSEISMICRE Seismic Residential B
I 1PPERMITFEE Plumbing Permit P
I
1 TRAVDOC Travel & B
Documentation
j 11BUSLIC Business License B
I
•
Sirkgle'Fa�nily GreenPoint Checklist date. �� Build It CrWi
TI ra GreenPoint Checklist is based on the various green features incorpoated into the home and is the Smart Solutions From Me Ground Up
basis for the GreenPoint Rated program.A home can be considered green It It fulfills the prerequisites,
same at least 50 ponds,and meets the minimum points per c=_tegoy.Energy(3D),Indoor Air Dualityl 1 ^I
Health(5),Resources(6),and Water(9).Plsase contact Build It Green fora Its,of qualified GreenPoint
Raters N you are interested in pursuing third-parry vallostion.
The gr=_n building practices listed below are oaspgbed in the New-Home Consrdaion Green Buil ding - II t
Guidalines,available at www.huildltoreen-oro. — .- -� _1 i ! I_._�
fu
nIe
U o w
U —
A.9
S I Points Available Per Measure
1.Protect Topsoil and Minimize Disruption of Esisning Plains ftrees
❑ a PML=m Topsoil mom Erosion and Reuse after CDnsfruct on 0 f
❑ h Umn and Delineate Construction Footprint se Maomum Protection
I ❑ 2,Desonstrvot Instead of Demolishing Existing Buildings On Site 0 3
3.Radycle Job Site Construction Waste(Including Green Waste)
❑ a.Minimum BO%N'asle Diversion by Weigh,(Ra_yrlfng or Reuse)-Aeons; 0 R
❑ b.Minimum fib%Diversion by Weight(Recycling or Reuse) 0 I 7
❑ a Minimum BO%Diversion by Weight(Recycling or Reuse) 0 2
4.Use Recycled Consent Aggregate(Minimum 2s%)
❑ a.Walkway and Driveway
Id.Roadway Base 0. .�
D I
Total Points Available to Site-1 p
B.FOUNDATION ( Poinis.4vaileble Par Measure1.Replace Portland Cement 1n Concrete with Recycled Flyash or Slag —
❑ aMinimum 20%Flyash or Slag
❑ 6.Idinimum ti%Flyash or Slag O
❑ 2.Use Fr.-I ro@Clad Shallow Foundation in Cold Areas(C.E.C.Climate Zone 16) D 3
1 ❑ 3.Use Radon Resistant Construroon On At-Risk Locations Only) 3 1
4.Design and Build Structural Past Controls !
❑ a,All Install Termite Shields 8 Separate All e3dar Dr WDDd-to-Concrots COrmn by M W PI -^F 1 DD'd p r
r j b. New PIaMs nava Trunk Base«Stem Ladatad At Is2s'3 Inch m F tl t a a 0
Total earn AvaPable in Foundation=B! D j
C.LANDSCAPING P310IS Available Per k4==sura
1.DonatruBt Pesourr"+Effieient Landsapes I
❑ a.No Invasiva Species Listed by Ca!-IPC Ara Planted
• ❑ b.No Plant Species Wll Require Hedging D0 n
❑ c.75%oi Plants Are DrougMiola:ant Caldomia Natives,Ideditzeanean,orOmar Appropdata Sp^cies 0
❑ 2.Use Fire-safe Landscaping Techniques 0 1
3.Minimize Tug Areas in Landscape Installed by Builder i
❑ a.All Tug Will Have a Water Requirement Less man is Equal to Tall Fescue(SD.B plant factor, 0 —
❑ h.Tug Shall Not Be Installed on Slopes Exceeding 10%or m Areas Less man B Feet Wide .--'- "'- --
I
E) c.Tug is st3PA of Landscaped Area(total2 points) -'-'o-- - ---- - -- _
1 ❑ d.TuA is<_ID%of La:tisaped Area(total 4 paints) � - '
j ❑ 4.Plant Shade Trees _0 _ ? I
S.Group Planes by Water o 3—
rN
Needs(Hytlrozoning) 0
6.Ins31I High-Efficient'Inigalion Systems -
❑ a.System Uses Only L.-Flow Drip,dult lem.an Low-fix Sprinklers
0
❑ h.System Hes Smart Controllers - 0- I ----- -- _ 3.
❑ 7.Incorporate Two Inches of Compost in the Top 6 to 12Inchesof Soil 0 3
❑ S.MULh All Planning Beds to the Greater of 2Inch.or Local Water Ordinance Requirement D 2
9.Use 50%Salvoged or Recycled-Content Matanals for 50%of Non-Plant Landscape Elements D ) 1
1I Reduce LigLM Pollution by ShieldingFixlurvs and/or Directing Light Downward d 1
Total Points Avalable m Landscaping=211 0 I
D.STRUCTURAL FRAME&BUU.DING ENVELOPE Points Available Per Ideesu•a
1.Apply Optimal Value Engineering _
❑ a.Place Rafters and Studs at 24-Inch On Center Framing )
E] h.Size Door and Window Harders for Load -� - -.
❑ c.Use Only Jack and Crimple Studs Required for Load
Z Use Engineered Lumber
❑ a Beams and Headers
❑ h.Insulated Engineered Headers 0
❑ c.Wood I-Joists or Web Trussas for Floats 0
E] J.Wood 6Joisis for Roof Raters
❑ e.Engineered or Fnger-Joint=_d Studs for Vertical Applications
❑ L Oriented Strand Board far Subiloar -- - c
❑ g.Oriented Stand Board for Wall and Roof Sheathing - -D- - g
3.Use FSC-00etl etiWood 0
❑ L Dimensional WrtfJer,Studs and Timber.Minimum 4r• __0❑ D Dimensional Lumber,Studs and Timber Minunum 70% 0 -- {
❑
c.?anal Pmdur,C 1.linim9 7um a0% -
❑ d.Panal Pmdu ns:Minimum 70% !
0 I
020D7 Build It G reen Single Family GreenPoint Cha_cidist 2007 Version Page 1 of 4
Ll
4.Use Solid Wall Systems(Includes SIPS,ICFs,6 Any Non Stick Fame Assembly) j
❑ I Flops p ] 2 I
• ❑ DWalls - — p
El c _j ��
.Food; j 2
S.Reduce Pollution Entering the Home hom the Garage j
❑ i Tightly Seal the Air Bayle Poll Garage and Living Area p 1
❑ b.Install Gambia Exhaust Fan OR Build a Detached Samoa .._p
6.Design Energy Heels on Tassel(7a,.of Attic Insulation Height at Coal Edge of Exterior Wall)
❑ ].Design Roof Truss.td Acsommodede Duebvork
LJ a.Use Rerycled-Con ent Steel Studs for 90%ol Interior Wall Fleming 0 1
LJ 9.Thermal Mass Walls:5Vnch Drywall on M Interior Walls or Wells Weighing more than 40161cu.1L j D j I
10:Insadersll Overhangs and Guj
❑ e.Minimum i&Inch Ovarhangs and Gutters 0 t
❑ b.Mirdmum 24-Inch Overhangs and Guners
Teal Points Available in Structural 9unding Frame and Envelope=351 0 j
E.EXTERIOR FINISH 'points 4vai'abl-Per Id=z—r?
❑ 1.Use PerydedContem(No Virgin Plastic)or FSC-Certified Wood Decking D 2 j
2.Install a Rein Screen Wall S}zdem 0 j 2
3.Use Durable and Noncombustible Siding Materials 0 1
4.Select Durable and Noncembol le Roofing Materials j D j z
—
Told)Pool Available in Exterior Finish 71 D j
F.INSULATION
P0inI9 Available Per lA?ZSDre
' 1.Install lnsulafon with 75%Recycled Content I j
❑ a.Walls anclor Floors
❑ b.Cetings
I Install Insulation that is Lcw- rndlting(Certified Banco 01350)
❑ .a.Wells anNp Flops
❑
It,Cern
I...D.. i
❑ 3.Inspect Oualiry o/lnsutation Installation cohere Applying Dryvjatl I D I 1
Total Point Avalahle in Insulations 51 D j
G.PLUMBING _ j Points Availabl?Per IA??su2
1.Distribute Domestic Hot lVaar Efficiently(Max'imum 7 Points). j
❑ a.Insulate Hot Water Pipes from Water Header to Kitchen I
❑ In.Insulate All Hol Water Pipes•
Elc.
I ,
c.Use Engineered tl PaPiping --�
El -I - - - - --.d.Use Engineered Parallel Piping with Demand CommDad Circulation Lapp 0
Ele.Use Summed Plumbing with Demand Controlled Circulation Loop "'-__
I—p
❑ I.Use Cental Cps Plumbing
2
❑ 2.install Only High Efficiency Toilets(Dual-Flush or 512B gpl) 4
Total Points Available in Plumbing=Teal fel D
H.HEATING,VENTILATION&AIR CONDITIONING Total
Points Available Per Measure
❑ 1.Demgh and Insall HVAC Sysam to ACCA Manual J,D,and S Recommendabons
D 4
2.Insall Sealed Combustion Units
❑ a.Furnaces L—
❑ b.Water Heater
I
3.Insall Zoned,Hydronicadiant Heating with Slab Edge Insulation 0 1 7
4,Insall High Efficiency Al,iConditioning with Environmentalty ResponsibL==Refrigerants j 0 j 1
P.Design and Insall Effective Ductwork
❑ a.Insall HVAC Unit and Dialoi within Condmoned Space j 0 _ 3
❑ b.Use Dud Made an AD Duct John,and Seams i- - 3
❑ C.Install Ductwork under Alto insulation(Burled Duels)
❑ J.Pressure Balance the Ductwork System 0 } _—
D I =.
❑ e.Protect DucS during Construction and Clean WI Ducts before Ou:upanry
D
6.Insall High Efficiency HVAC Filter(MERV fir) 0 j 1
❑ 7'Don't Insall Fil or Install Sealed Gas Flaplaces with Efficiency Rating Not Less Than 507, 1
using CSA Standards p
a.Insall Effective Exhaust Systems in Eaarooms and Kitchens
❑ a.InslaA ENERGY STAR Bathroom Fans Vented to the Outside p
�.
❑ 0.All Bat Fens Are on Timer p Humidisat
❑ 'c.lnslet Ktichan Range Hood Vantetla the Outside _ D
9.Insall Mechanical Ventilation System Tor Cooling(Maximum 4 Points) i
❑ a.Ins;aD ENERGY STAR Gift'Fans a tight Kits in living Ares A Bedrooms D t
❑ b.lnstall Whole House Fan will)Variable Speeds
❑ C.Auloanatically Controlled Integrated System
❑ d.AutomatiCal Controlled Into ad System Mth Yanable 0 Z
Automatically IR Y Speed Control 0 — .....
10.Insall Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House Ventilation System That Meets ASHRAE 621 7
❑ b.instill Ak-lo-Nr Heat Exchange Nat mens ASHRAE 521
• LJ 17.Insall Carbon Monoxide Alarms) 0 1
Total Poing Avalab:a m Hsafngn ilation and W,Va;
rCanddiming=37 0 �
Compuniry.Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
SJPERTINO
Building De artment
JOB ADDRESS:22(, 3q S+4-" q�,l,rA- PERMIT # DI 17
OWNER'S NAME: I P, S,a PHONE # 06- P53 Ya3
GENERAL CONTRACTOR FAX #
I am not using any subcontractor .
Signature Date
Please check applicable subcontra rs and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
IMF Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
r/ Plumbing l
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
• Qbr231 O'7
Owner/Contractor Signature Date