08090028 CITY OF CUPERTINO -
BUILDING DIVISION PERMIT , CfO,NTRAGTORINI+,OItMATION �'
BUIL91�1CLAgI�R TILSON AVE TBD — TO BE DETERMINED P 08090028
'NEWS NAME: PERMIT ISSUE DATE
DONG KYUN AND NAN YOUNG KANG 09/05/2008
PHONE: SANITARY NO. CONTROL NO,
AacxnEcnFi+clrgEER: WFO
REMOVE EXISTING GAS LINES TO 'BLDG BUILDING
ELECT PERMIT PLUMB MECH
290:7 upe
0 0 LICENSED CONTRACTOR'S DECLARATION O O O O
En I hereby aRirm Net I un licensed under provisions of Chapter 9(commixing Job Description
ii wlNS gon7")ofDivtdon5ofthe BusimdPrafcLsimCode.and mylkcnmu
<d in full forte and east •�
DM? License CI Licg '5if O
ni- mr
Dow Coacton
pp ARCNITECI'S DECLARATION
I understand my plane shall h used a public mcmd,
'W'
k W ti Lactated Proks onal
3 OWNER-BUILDER DECLARATION
ji x I hereby amm that I am egcmpt fmm Ne Contractors License Law for the
OO rollowing won.(Section 7071.5,Business and Pmfessimu Code:Any city or County
S$ which tequims a permit m construct.alcor,imprme,demolish,m¢pair my structure
_Z< prior m its issuance.also requires lh applicant forsuch permit to file a.ignedsmtCmme
i€o NRrm
.theislicensedputtl.Neproaa
smmnftheCmeemLou. pCh.,scrr9 Sq.Ft. Floor Area Valuation
�( (eommen6ngwiNS on7000)of Division3af Ne Busin=ss dProfe amCode)w
S
that i .exempt therefrom and the basis for the alleged ea eptim.My violation of
Section 7071.5 by acy applicant for a pemb subjects to,applicant in a civil penalty of ane APN Number Occupancy e
rot mem doe RK hundred dollars($($-'On
Y o �P
❑Luawnv oftha pnpmy,amy employcm with wagauth'v sokemmpew0on,
aid Professions
and Ne be Co a ismtktemed er a w do tarok(Sec.Joan,Budin of
me property
bis cmc:mp cenEn cor,urwe oes ache act apply lf an owner is Required Inspections
momenywho Wlldamimpmt that such impr,andwho areseuchwohhimxu edNmugn his
awecm.thees,doNor motowcn imps mid wuartne intendedrofcmoBued fw sales.
bowery.the aw than,
or impmmnmt k sold a within one you of Completion,than rwnv-
Wilder .will love th burden of proHng that h aid not build or improv for purpose of
sok.).
0 1,as owner of the property,am utludvcly conoaning with licensed Conuactms in
Comtrum the proFm(See.7(160.Bmincn and Professions Cmc)Thu Contractors Ii.
KNe Law dam not apply m an Comet of p nmCrty who builds or ImpmKe theme.ad.
who Contracts for such projects with a cnnwctor(s)licensed pursuant in the Conusectors
Lkerue Law.
0 lamvemptunder See .03PCfmthioresson
Dan-
4
WORKER'S COMPENSATION DECLARATION
1 hereby dnmm under penalty of perjury one of the following declarations:
❑I haw am w01 muntsio•CvtiOam rfCovent m self-imurt Ire WorkorsCompere -
atim,u provider fm by Section 7'100 of Ne Iabm Cone.far th pedomaem o(dx
work for which this permit is issued.
0 1 haw and will maintain Workers Compensation Inemanm..s required by Seems -
77W of the labor Cone,for the pcdormancc olden work furwhiGt this permit is issued.
My WorkC�s Cyom�fp�emw.ado�nn IItu�uta�na caaiv and Policy number me.
cant Lr/Y!K) Policy No.: 1
CERTIFICATE OF E%EMPRON FROM WORKERS'
COMPENSATION INSURANCE
Crhissatim need ret be completed if ins,permit is foray hundred dollars(6100)
or Imt)
1•-..:fy Net in th pvfrm mm of the work for which this permit is issued.l shall not
employ any person in my manner m as In become subject to the Workers'Comp useadom
Laws of California.Dam
Applicant
NODCE TO APPLICAN..If.after making this Certificate of Exemption.you should
baome subject m the Workers Cmmpematim pmvuiom of on,Lapor code,you most
.J O forthwith comply with such pmvisiom W Nu Permit Nall h deemm rnaked.
'�y CONMUCnON LENDING AGENCY -
(-m.•. I herby afftm thu Vert iso Comsuuetim knding agency for the pufmm.of
aiNe work for which this permit is named(Sce.7097.Civ,C.)
131 Q Lendore Name
7 z Lcmers Address
U O 1 Certify that I haw mad Nis applicedon and stem Nat Nc above information It
U. ^. Correc6 I-gra b complY with LI city and county rottenness and sum tan relating b
Wilding croswc0on.and hereby auNunne,repostroom s of this city to rnrmupon 0e
aabilim judnedproperty for inspection purpowhich a
s.
(Wel agra m saw,indemnify and kap harmleu time City of Cupertino spinet
f/1 in
of the
expeevawhich may in urynyacmue agaimtsefd Gty
U z in eomeguenee of Nr granting of this permit. y/ � Y�
APPL NT UNDER DS A ILL COMPLY WITH ALL N -P Issued by: Date / -_T!'
so cE uu
Re-roofs
V�=
uConvacmr
s HAiARDOUS MATERIALS DISCLOSURE Type of Roof
It plicant w(retire Wilding ocapan.smrt W handle hacardom mauritl
Ne Cupertino M pal Cmc.Chapter 9.12 and the HaIN and Safety
zsss7(a)7All roofs shall be inspected prior to any roofing material being installed.
a.
Will
If a roof is installed without first obtainingan inspection,I agree to remove
dm applicant or fumm Wilding aavpant use equlpnant m mksias which Pe g
Di it hcaans ME,emm
rdomie.nIs defined by NA.e Bay AAir Quality Management all new materials for inspection.
0Ym o
I haw mad Lou haruNus mued-isrequiremmts under Chapecrd.95 ofthe C-lifor.
ni- S. 25576.ImLLnuam NCO Wil'ng
does no c nay haws Nen it u
my responsibility b no dm ne pmt done
mgmim whrnm pri ismanaof.Ccmreamor ry. Ig at eo plicant Dat
owner auNari ascotare All roof coverings to be Class')?.-'or better
w, Community Development
41 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
86/ ZO
OWNER'S NAME: CLh L PHONE # t
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
ignature 6ate
Please check applicable subcontra s and complete the followinginformation:
ba 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
Owner/Contractor Signature Date
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37516038
DATE ISSUED. . . . . . . : 09/05/2008
RECEIPT # . . . . . . . . . : BS000006008
REFERENCE ID # . . . : 08090028
SITE ADDRESS . . . . . : 18861 TILSON AVE
SUBDIVISION . . . . . . .
CITY . . : . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DONG KYUN AND NAN YOUNG KANG
ADDRESS . . . . . . . . . . : 18861 TILSON AVE -
CITY/STATE/ZIP . . . : CUPETINO, CA 95014
RECEIVED FROM . . . . : CURRO PLUMBING
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . .
• TELEPHONE . . . . . . . . :
FEE ID UNIT . QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 3 , 700 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1BUSLIC FLAT RATE 1. 00 110 . 00 0 . 00 110 . 00 0 . 00
1PGASRES OUTLETS 1 . 00 61 . 19 0 . 00 61 . 19 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40.79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 253 .27 0 . 00 253 . 27 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 253 .27 . 1394 , -
---------------
TOTAL RECEIPT 253 . 27
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING
506 GAS TEST 507 FINAL PLUMBING
•
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPERTINO PERMIT APPLICATION FORM
0
APN# Date:
o 3 8— -
Building Address: /
b �
Owner's Name: n � Phone#:
Contractor: Phone#: qW-
Fax #: ye)8-Sy7���e r3'
Contact: Phone #: yip,e0s'
Contractor License#:
Cupertino Business License#:
Job Description:
:5ZSS fru
Residential Commercial ❑
Valuation:
Project Size: EvpressW 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 BuildingPoints:
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
IBPREPIPE Commercial re-pipe per fixture P 1CPRP
IPGASCOM Commercial Gas Piping System P
1-4 Outlets
IBSEISMITCOM Seismic Commercial p
IMF 1BSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
aC10F REPIPE/SEWERIMAIN SERVICE
CUR, TiNO FEE SCHEDULE i
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
iBPWSVCS Water Service P 1CPWS or
1RPWS
IPPRSEWG 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 1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
/ 1PPERMITFEE Plumbing Permit Fee Issuance P •
IPLM 3LNCK Plumbing Plan Check P
1PLMBINSP Other Plumbing/gas Insp. P
/ 1TRAVDOC Travel &Documentation Fee B
\ IBUSLIC Business License 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 paints
11. Permeable Pavin , Nota L•1 2 Dints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 paints
D. Structural 3. Uses Wood (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 oints
E. Ext. Finish 1. Composite Decking, (Nate/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 Dir is
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 Dints
G. Electrical 4, E. Ceiling Fans, (Note/Spec.) A-3
__Lpoints
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) AJ 1 point
3. Enemy Star Refrigerator, (Note/Spec. A-3 1 Dint
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
•
Plan Review Protons Work Book Page-12-Revised 3!1.5/08
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
I1 Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points 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
18.Design Resource-Efficient Landscapes and Gardens _ _ 4 Resource pts y=yes D
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 D
1 i 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 p
1 1 !
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber __ i 3 Resource pts y=yes p
2.Use FSC Certified Wood for framing J
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. D
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 p
6.Use Flinger-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 p
12.Use OSB -
• a.Subfloors 1 Resource pt y=yes 0
b.Sheathing _ 1 Resource pt y=yes p
0
1 1
D.Exterior Finish
1.Use Sustainable Decking Materials •
a.Recycled content 3 Resource pts y=yes 0
b.FSC Certified Wood 3 Resource pts y--yes 0
I2.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
�_Use Fiber-Cement Siding Materials 1 Resource pt y=Yes 0
{ { f
E.Plumbing
1.Install Water Heater Jacket -
-- adkit 1 Energy pt Y=Yes 0
2.insulate Hot and Cold Water Pipes 2 Energy pis y=yes 0
C3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. D
� b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. D
I4.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 Showarhead 1 IAQ/Health of 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 IAQ/Health pts. o
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 F
r,caeccncar
I1.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 pfs. D
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 of 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 D
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
�3.Install-Recycled-Content,Fiberglass Insulation with
IND Added Formaldehyde _ _ _ 3 IAQ/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 D •
b.Ceilings 4 Resource pts y=yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Wells 4 Resource pfs y=yes 0
D.ueilings 4 Resource pts y=yes D
{ 1 1
INPUT ReSDUTCeS Energy 1ADIHealth
I.Windows
• 1.Install Energy-Efficient Windows
a.Double-Paned, 1 Energy pt Y--yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames J 2 Energy pts yyas 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
t 1 t
J.Heating Ventilation and Air Conditioning
7.Use Dud aastic on All Dud Joints _ i 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 IAO/Health pts y--yes 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
B.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-yYes 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 stoveslnseds 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 41AQ/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 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 p
4. Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=16 points) Up l0 7 B Energy pts 0
6.Select Sate and Durable Roofing Malenais _ _ _ 1 Resource pt y=yes 0
7.Install RaaianfBarder - 3 Energy pts y=yes 0
DI_ 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 p
—J--
LJ
• 1 I 1
INPUT Resources Energy IAQIHealth
M.Indoor Air Quality and Fwshes
,1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
11 Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Intenor Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61A0/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
17.Seal all Exposed Particleboard or MDF - 4 IAQ/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 IAQ/Health pts y--yes 0
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 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=yesl 1 0
1 1
Total Points A 1 1401 1301 57 •
Total Points Project Received: 0 0
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