08040191 CITY OF CUPERTINO
BUIL
DINp mvlsl.ON PERNIITCQ1)ITR�I.CTO I1�IFQItMAT ,- N"--
xa. .:» ws
BUILDING ADDRESS: - PERMR NO.
23030 STONEBRIDGE ST LOEWEN & FRECH INC 08040191
OWNER'S NAME: FERM7r ISSUE DATE
JOHN & MICHELLE KAPLAN 245M MT HERMON RD 04/28/2008
NE: SANITARY NO. CONTROL NO.
8313354632
ARCHITEC`r(ENGINEER: BUILDING PERMIT INFO
BLDG EIELT PLUMB MECH
30o LICENSED CON'fRACTOR'S DECLARATION O
1 hereby affirm that 1 am licensed under previsions of Chapter 9(commencing Job Description
with Section 7")of Division 3 of Um Buaineu and Professions Code,and my license is R/R EXST 60 GAL W/SOLAR ELECTRIC WTR HEATER
n in ull face and effect (�
�gz uefense Cl Ix.g9 J2S .
Dam — Contracts Yn
1 n rtECrs DEcu A IDN
Q 6W U akernand my plans Mall Im used as public records
k O Licensed Professional
5 OWNER-BUILDER DECLARATION
ConitON
COO bonthy,(Sere on I am
esempl Item the Cssion ofa License city
o for Um
COO o following won.(Section contra Business and profession Ceee:My coy or county
9 which its Wa t permit re erns,ft alter.Improve.h Permit
or i repair,and moment
y pderm its iuunegalmnt to the thovisioont for Conusc o's LicessLnedstsmmcm -
8< Nu he osemit ithSue,mboth)ofDivision3Neconhsis.andProe�on,Codm 9 Sq.Ft. Floor Area $1500 Valuation
that he Is are with Secifices and
the
Dannon r of the ausinwend on.Any
Cade)of 5 0(]
Nal Section
ts campy Nerefmm and or burr for be allegon emmpriom Any violation of
not. 70]IsbyuryApplicant ddollrGIammitmbicwln�.ppucantmactalpmaltrer Number Occupancy roI mom Nan Rw bnNred crews(s5am. 3 4 213 014 �(�- P Y T�Pe
I,u owns of tW property,army employees with cages u UmUsole canansation.
willdo Ibowak,and Nemuause ts rotimm�d aoRead forule(Sm.7W,Business
and Profession"
Code:The Comnacmfa LicNIY Law does ml apply to an owner of Required Inspections
property who builds a tmpsoves Ihenton,and who duce soh work Mmself o through his
own employees,prm'ids l that such improvements K not Intended aoaesed ferule B.
how..Ute Wilding a imPM.L tssold within uses year of mmpleder.Ne owner-
Wilder NB have that Wrtleo of pmHmg that W did mn Wim or improv,for purpox of
sale.).
❑1,u owner M the pmperty,am exclusively contracting with licensed contractors to
cominal Ne pmjea(Sec.7044,Business and Professions Cutlet The Contractor's Li-
cense law dos not apply in an owner of property who Wilds or improves themes,and,
wbo contacts for such projects with aeonmmo(s)licensed pamtsmt to that Comacusts
License law.
❑Ianeumptunder sem .B&PCfathis ..._
0 Dam
WORKER'S COMPENSATION DECLARATION
ntby arm under penalty of perjury one of the following declarWons:
low and will maintain•Coruscate ofConsenl to self-Inswe for Weaker'sCompcn-
souther.as provided for by Sectio.3700 of tins:Labor Cole,for the Purl.. ce of Ne
weak for which NIe Perch is Mood.
❑1 have and will maintain Workees Compensation Insurance,u required by Secnen
5700 of the LaborCode.for the performance of Ne work for which this permit is Wood. '
My Worker's Compensuion buurance carrier and Policy number art:
Cartier Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be complead lithe permit is Ter one hundred dollar(SIM)
or Iesq
1 cam iry Nat m Use performance of Use we fo which this permit in Wad,I shall not
employ any person in mym er outs ore sobje tmUcwor n'CompawUa ,
Laof Califund Dam
Applicant -
Na7CE TO APPUCA wall
++ Ig Nu Ceninute of Eamption,you should
become subject m Ne Woher's Comllen Won pmMeions of Use IaWr Cedc,you muss
Q O forthwith comply with such provisions a Nis permit shall be darned octomd.
Z y CONSIRUCrION LENDING AGENCY
E. 1 hereby amain thin umbo ts a convection lending aaney for the performance of
Cthe anal,for which this permit I.issued(Sec.3097,Civ.C.)
W Lender's Name ,
.7 Z Lundeen Address
J Q I certify Nu I haw mad Wa mplicuion and sub Nu Um above infomutiun u
(L^ rolmtt I agree to comply with at]city and county oNinaaes and sum laws misting to
Q SV^ Wildingeonsunmion,and hembyauham.rtpmunwlw of Nu city menmrupnn the
wit aWve-mationed property fa imams purposes.
fY (We)Agra to eve,indemnify and kap humlm the City of Cupertino sgalnst
yy A Iiabllides,jndgrams,cesu and a meawhlchmaylnmy MyaeLTCapinstrtid Cky
()^ APPLLhCgA Taft)De AN o ND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE R -n o
Re-roofs
Signwum o(App ioHA r Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
pal by the C.1"l m future Wildl ampantemm nand t e hauNou mScdrl
u de0roe by Uc Cuania Munici see.Chapter 9.11.and the HnIN and Safety
Code,satin 2555:(.)7
C)yes All roofs shall be inspected prior to any roofing material being installed.
a
Will applicant or future uac Wilding occupant cquipmmal defies which If a roof is installed without first obtaining an inspection,I agree to remove
huutlnwthe
I,..I. u ned by the Bay Area Air Quality Management all new materials for inspection.
' <tT
❑Yes Nu
T haw read NehusNmum nalsmquimmenuunder Chapter G95ofnmCalifor-
nuHesl"SafetyCode.Satiaa .25513wu125f3a.IwalaranldthmifUc budding
dace rot cvareml he s ani Il'u mY respon jollity m muify the occupant of the
mquimmenu met ra6an ncertiflumefOcen� Signature of Applicant Date
F/ !�E i
OwmereranNemJagem Dam All roof coverings to be Class'%?."or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 34213014 . 00
DATE ISSUED. . . . . . . :• 04/28/2008
RECEIPT # . . . . . . . . . : BS000004592
REFERENCE ID # . . . : 08040191
SITE ADDRESS . . . . . : 23030 STONEBRIDGE ST
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : JOHN & MICHELLE KAPLAN
ADDRESS . . . . . . . . . . : 23030 STONEBRIDGE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5641
RECEIVED FROM . . . . : LOEWEN & FRECH, INC
CONTRACTOR . . . . . . . : LOEWEN, DEBRA LIC # 21212
COMPANY . . . . . . . . . . : LOEWEN..& FRECH INC
ADDRESS . . . . . . . . . . : 245M MT HERMON RD
CITY/STATE/ZIP . . . : SCOTTS VALLEY, CA 95066
TELEPHONE . . . . . . . . : 8313354632
FEE ID UNIT QUANTITY AMOUNT PD,TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ------ --------- ----------
1BSEISMICR VALUATION 1, 500. 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
ITRAVDOC 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 #10302
---------------
TOTAL RECEIPT 106 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- `---------------------------
518 WATER HEATER
•
CITY OF CUPERTINO
WATER HEATER
CI Of
9CUPEIIaTINO PERMIT APPLICATION FORM
APN # .� L/� 13 0 0 0 Date:
Building Address:
25()-2 v 1$j e�r�Ia�r
Owner's Name: Phone #:
Ma V 11,45 . T(,*)g74tw KA19LAN
008 FQS- 616"7
Contractor: Phone #•
Lc�e� n � � �Nc (45)
Fax #: 31 ?�5-0-552
Cupertino Business License #: Contractor State License #:
21ZIz yZ��� I
Contact: Phone #:
Eq � Fax #: �D
Building Permit Info:
Bldg ❑ Elect Plumb �� Mech
Residential Commercial ❑
Job Description:
-Move I �v puke �t isr 80 �
Strapped Ej/�On Platform Bonded ET"�New Location ❑ Replacement
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to
lei the application or if applicable, include in plan set & the sheet index.
Green Building Points achieved: _
-�, CITY OF CUPERTINO
' WATER HEATER
CUPEI�TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
HeaterNent
IBSEISMICOM Seismic Commercial B
1 PRWHEATR Residential Water B PRAMATR
I HeaterNent
1BSEISMICRE Seismic Residential B
IPPERMITFEE Plumbing Permit P
/ ITRAVDOC Travel & B
Documentation
1BUSLIC 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
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. A4 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 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
2 r3b3o
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 Resources Energy IAO[Health
. ite
1.Recycle Job Site Construction 6 Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materiels J 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
B.Design Resource-Efficient Landscapes and Gardens 1 4 Resource pts y=yes 0
9.Reuse Matedals/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 I I
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 pts0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy y=yes 0
mm1
C.Structural Frame
[i.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
8.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
1Y05--m — I
_
a..SSubfloors 1 Resource pt y=yes 0
• b.Sheathing _ I 1 Resource pt y=yes 0
1 1 1
r
xter or n s
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y=yes 0
b.FSC Cedified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAO/Health pt y--yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt yryes 0
1 1 1
E.Plumbing
ater Heater Jacket 1Energy 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 Tollast 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 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
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
r.eiecmcai
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs 4 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 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.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes 0
1
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Wails 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 3 IAO/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Wails 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.Ueiungs 4 Resource pts y=yes 0
INPUT Resources Energy 1ADIHealth
"Sows
1.Install Energy-Efficient Windows �-
• e.Double-Paned ; i 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 D
L_ _
2.Install Low_Heat�Transmission Glazing 1 Energy pt y=yes 0
1 1 1
eating Ventilation and Air Conditioning
I1.Use Duct Mastic on All Duct Joints _1 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
S.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 31AQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/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 stovestinserts 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 Filler 41AQMealth 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 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
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
r6I .Select Safe and Durable Roofing Materialsi__� 1 Resource pt y=yes 0
7.Install Radiant Barder 3 Energy pts y=yes 0
1 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 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
1 I
INPUT Resources Energy 1ADIHealth
. n oor r ue ty en n s ea
1.Use LowNo-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
3.Use Low/No VOC Adhesives 3 IAO/Health pts y=yes 0
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
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
8.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 IAQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 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 4 Resource pts y--yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total Points Available: se) 130 57
Total Points Project Received: 01 O=
G:datelprogstgreenbulldmgguidelinedremodelem/gmmpoinlsf na12.12.e4pmteded.ds
Community Development
10300 Torre Avenue
j .4✓ Cupertino CA 9 014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
qFUPEkj1N0
Building Department
JOB ADDRESS: PERMIT #
Z 5o 30 e i2-:,2c fX� OJ�-D C(a
OWNER'S NAME: ':T N A4'4AN PHONE $-3/)-3354(f 2
GENERAL CONTRACTOR: y, KF/ FAX # S-OS2-
I am not using any subcontractors: keII 27o
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
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/ ontractor Signature Date