08070177 (2) CITY OF CUPERTINO ,w.aae. 3m YS - ' t
BUILDMG DIVISION PERMITCUNTRAG�T(3R TNFURMATION 4
BUILDING ADDRESS: PERMIT NO.
10304 DENISON AVE CUPERTINO PLUMBING 08070177
OWNER'S NAME: PERMIT ISSUE DATE
NRLSON D' SUSZA 1300 DELL AVE STE C 07/24/2008
NE: - SANITARY N0, CONTROL NO.
ARCHIEC(ENGINEER: BUILDING PERMIT INFO
WATER MAIN BO EO PLO O
�O O LICENSED CONTRACTOR'S DECLARATION
uC I hereby affirm that I sm lheue i under provui.0.f Ch%Pmr 9(tommc mmil Job Description
ZW vith Section 70()(1).1'Division 3Of9.Bowdera add Rafessiom Code.and my licensee
fanf.la,nd cfr«, d
?�Z License Clus •_ ® lie.N
p Dase Cornu cm, — N" e
447W A Hr1ECTSDECLARATIOt
'W U 1 undersand my plw shall he useA u public rmdords
g o In Licensed Professional
5 OWNER-BUILDER DECLARATION
.� M i hereby aRnn that 1 am exempt from Ne C.nuacmer license Law for Mm
i O O following mason.(Section 703 IA.Business and Profusions Cale:My city Or county
which acquires•permit or cm ardct.alis.improve.cicemlLN,or repair any awcture
print b is usuaxc.also requires the applicrm for such permit m file a signed satemcnt
Q Nat he is licensed pumanuoOnpmu
visimofMeCormamum'sLiaueLaw(Chapter9 Sq.Ft. Floor Area Valuation
E{ a (cmmmcnaing with S vion 7000)of Division 3 of Ne Business and Profeaiou Cade)ar
S ME M Is exempt therefrom and Ne btu for the alleged exemption.Any violation of
Settled 7031.7 by any applicant fee a permit subjects Ne applicant to a civil penalty of ane APN Number Occupancy e
dot mom Nass five hundred dolor,($500). P Y�P
0 I,u owner of aha property,or my eroplaycex with wags as,thebsolexmperuaMon,
.. wiBd.thework,and Nmatmctumunm NtendndoroBeredforsate(Sx.7044,Busineaa
and Pmrcaaati coder The c.mactm s License Law does a.,apply m an Owner of Required Inspections
p opertYwho Wilda orimporm rnermaand who aousxhwor himsedfor through his
awn amploym,powidnd that such improvements art not Mannino oroRened ftessle It.
however.Ne building or imp..toart t 4 sold within ane year afcomplm i.a.the owner-
builder will have Me bmdea of proving that he did set htid or impro a for purpose of
anleJ.
0 1.u Owner of Ne property.an exclusively contracting with Moved rnnuactaa he
muton the project(Sec.7044.Business and Professiou Code:)The C.nusco's Li-
ccom Law does not apply to an owner of property who builds or improves Muccon,and.
wM conumu fm such pojecu viN aconuxmrts)Ilttued puuuam m Neconvsmor" '
license Law. - -
0lameaampturearSee .B&PCfor Nu woo
Owner Due
WORKER'S COMPENSATION DECLARATION
1 hkreby a1Rrm under penally of perjury ane of thm following d mdmtc
Ihatandwill.xoom.a Certifrcaaofconsentmelf.irimfm Wa SCanpem
,amen.as provided rte by Sectiao 3700 of the Labs core,for the perfomtamn of we
work for which Nis permit is hated.
0 I have and will malmaln Wormer Computation Insurance.u mgdrnd by Section
3700 of M Labor Corte,far the performanec of the woe forwhich this permit in issued.
My Worker's Compeuation Insurance,artier cad Policy number are:
Carrier.. tit �waa.�.(— Policy No.: �rGj'�T—GtZ
DERnFICATE OF E](bmolx FROM WOiiiCF�'
COMPENSATION INSURANCE
Cutis section need ant be completed Earn pewit Is far one hunNert damon(S 100) .
ar
hose.)
I xrufy Net in the pnerro more n of the work for which this Permit is issued,l shall was
ernplq ray perm.in any..r an u an become abject to Me Warkta'Compensation
Laws of California.Dau
Applicant
NOTICE TO APPLICAN..If,after making this Certificate of Fsemption.you should
become subject as the Workers Compensation provuiou of the,Isbor Code,you mut
Zforthwith comply with such provisions or .mrod Nis peit"I he ancmvoked.
O
z y CONSTRUCTION LENDING AGENCY
I hereby allim NU Nae is a couwNnn lending agency for the letrorman eof
C > Ne walk for which Mm permit la issued(set.3097,cm.C.)
Q Lender's None
.;. z lenders Addw
U O 1 xrtify that 1 Wase w this applicadm w sate than Ne abme womada,Is
I,r^ tamed.I same to comply wrN all city and county.di^aRGt and sum 1.rtimmi,to
O Sl'J: building construction,and hereby mNada mpwnuMms of Nu city to enurupon Mc
� shave-menMaro Property for irupedUon pugare.
g1a (We)ague m ave,indemnify and l xp harmleu the City of Cupertino agai s,
fn incoiMcs,jWgmenu,coauand expeveurnah, may in any way mrncapWttalrt City
U z in eovegruax of Neganunj of this permit
^w APPLICANT UNDERSTANDS AND COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATI
7-2v-a3
srgnumea�, eanvCan etre Re-roofs
Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or(mune building Occupant stem or handle haosrdout manurial
u de0u s!by the Cupertino Municipal Code.Chapter 9.12 and the HcaM and Safety
Conn.sectfm 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
ONO N.
❑Yex ❑
Will the. Bart or mare Wilding occupant am If a roof is installed without first obtainingan inspection,I agree to remove
PP 6 W equipment Mann which P
t huadnw air cmamiunts u defined by the Bay Area Air Quality Management all new materials for inspection.
District?
QYea Nu
1 have read Ne ha>vdnusmareriau recto mmems underC1,aphr6.95 orthe Cantor.
nit H-hh&Safuy Cade,Snedem255a5,25533 and255M.1 undersand NuifMc WMErtg
does Out twentlY hath a aunt.than it is my responsibility m rcufy the occupant of the
mgaimmenawhi acts af.0 tire, a gamy. Signature of Applicant Date
Z Y All roof coverings to be Class'WI or better
OwneranuNamcd agcm pam
CITY OF CUPERTINO
• 4 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot':
APN 31629063 . 00
DATE ISSUED. . . . . . . : 07/24/2008
RECEIPT # . . . . . . . . . : BS000005576
REFERENCE ID # . . . : 08070177
SITE ADDRESS . . . . . : 10304 DENISON AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. NELSON D' SUSZA
ADDRESS . . . . . . . . . . : 10304 DENISON AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2429
RECEIVED FROM . . . . : FRANK CARDIA
CONTRACTOR . . . . . . . : CARDIA, FRANK L LIC # 612
COMPANY . . . . . . . . . . : CUPERTINO PLUMBING
ADDRESS . . . . . . . . . . : 1300 DELL AVE STE C
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 253-0618
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- --------- ---------- ---------- ---------- ---------- ----------
16PWSVCS WATER SERVICE 1. 00 20 . 40 0 . 00 20 . 40 0 . 00
IBSEISMICR VALUATION 1, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
113PERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1'i'RAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 102 . 48 0 . 00 102 .48 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
•
OJO-7 0/ 77
�� ` CITY OF CUPERTINO
d
R REPIPE/SEWER/MAIN SERVICE
• CUPE{IiTINO PERMIT APPLICATION FORM
APN # Date:
,37 (, a 9 v �,3, v cv `7 -2 4 08
Building Address:
0U 1 p
Owner's Name: Phone#:
9-C-1 Sc?y-) O 2-55 - 395(
Contractor: Phone#:
253- 0G18
C-k� Fax #:
Contact: Phone#:
Fax #:
Contractor License#: 6Zc.j cy s
Cupertino Business License#:
Job Description: �1
Residential Commercial ❑
Valuation: /r d c.) c5--
Project Size: Express nStandard ❑ 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
IPCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial p
IBSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P IRPRP
IBPWSVCS Water Service P ICPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
IPCESS Cesspool P
IBPWATER 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
IPPERMITFEE Plumbing Permit Fee Issuance P.
IPLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
1 TRAVDOC 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
Y '
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/S ec 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 Doint
P. Other 1. List Green Features on Plans A- 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 ReSDUrCeS Energy IAO[Health
A.Site
1.Recycle Job Site Construction&Demolition Waste''
65%=1 point;75%= 2 points;80%=4 paints 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
B.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse MatedaWUse Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irdgation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 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=yesF:::: 0
1 1 1
C.Structural Frame
1.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 pis 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 pis 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
12,Use OSB
a.Subfloors 1 Resource pt y=yes 0 •
b.Sheathing 1 Resource pt y--yes 0
1. in ows
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 2 Energy pts yeses 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
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- es
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 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
8.Install Sealed Combustion Units
a.Furnaces 31A0/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 stovesfinserts 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 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 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 1 B Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes p
1 1 I
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 1 I
Community Development
4 10300 Torre Avenue
' x✓' " Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
OCUPERTINO
Building Department
JOB ADDRESS: PERMIT #
10 3D ,-� Ogf6"d 0 M
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: (2kp pt lz FAX #
V.
I am not using any subcontractors:c��---- �/�'��
Signature Date
Please check applicable subcontractors and complete the followinginformation:
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