08070194 (2) CITY OF CUPERTINO
BUILDING DIYISIOM- - - PERMIT CONTRACTUIt INFOItMATi„ON
BUT 9.INO0.�'8rFSD S: PERMIT NO.
DENISON AVE YB CONSTRUCTION 08070194
OWNER'S NAME: PERMIT ISSUE DATE
NELSON D' SOUZA 10795 MINETTEDR 07/28/2008
NE: SANITARY NO. CONTROL NO.
(408) 316-1261
ARCHnECf,ENGINEER: BUILDING PERMIT INFO
BLDGO EO PLS MECH
O
�Op LICENSED CONTRACTOR'S DECLARATION VOA
m 1 hoeby affirm that 1 as licensed under previvJob Description
of Chapter 9(commencing P
with Secflan700(fafDivisiot3aft Business and ProfeAdauCode.mal my]i..ins INSTL 2BTHRM EXHST FNS W/NEW ELTRCL CONN&SWTCHS,
TI N in full tome and a rm.
Vim: Lie.mucl..r Wc.g INSTL RCESD LTNG W/ELCTRCL SWTCHS& RP,LC EXTNG
a t-q Dau Coolrctar
7W ARCHITECTS DECLARATION THERMSTAT(4)
U I uMersunJ my plane Nall M used u public retards
yI”„ Licensed Professional
3 OWNER-BUILDER DECLARATION
I bench,aR
from that 1 am exempt from the Cant mor's ueanse Law for the
00 following moon.(Section 7031.5,Busiiuu and Professions Code:Any city ar county
$9 which requires•permit to continues.allu,improve,demolish.or repair any saucmm
�0
_iit prior bins iauvee.Nsu reqs,ire lM rmm fi
appli.t for such peit laaaigm
rud muou that he is licensed Pursuant to the provisions ofthe Conuacter'Wanm Law(ChaFte,9 Sq.Ft. Floor Area Valuation
�E{ (commencing with Section700()af Division 3aftM B..i..d France..Code)., $1200
S'3 9 dist he is exempt then from and the basis fee IM snuffed esempuon.Any violation of
Sccdon 7031.5 by any applicant for.permit subjects,the applicant to a civil Porosity of
ml rom Nn five hndred dollars(SM 31629063 Number Occupancy Type
I,u owner of IM pmpmy,or my wploym with cages u the'vsulc eompenudon,
and do Newary.ands, he Com Isrwts Lictede Law doss eek to an Busies
and property who ns code:The Contrselar'.n. ndwho Law arch,eat apply m m owner ar Required Inspections
mecou who ,mirds miultmwesch improvements
is doessuchwmk himseiforthr rade his
howemplaym,provided prsuch imPsmem wtare mtiear acdend orarfend planfor U.
hunder.in Wilding u imprormmmng aid within arc Wild
or mpro a forn.purpose
ase of
Wilder w10 haw Ore Wrdcn of proving Nan M did Out build m improv for puryoa of
ale.).
1,u owner of Na Property,am exclusively...trming with licensed mntraclan b
construct One project(See.7014,Business and Profcuions Cada:)The,Cmua[mh V-
cmue Law dines not apply to an owner a Pto cony who Wilda Or improves Neuron.and . .
whomntnus far. ProlecuwiNaconuanor(s)ti =dpmuanlmmMCan=Wes
Lae.V -
❑lam dmf Fe .B&PCfm Nis
Owner Due
WO CER'S COg (BAT10N DECLARATI-
I hereby of nee under penalty of facility ons of the fallowing declara0ome
1 ham and will munuin•Cur inataof Covent in self-insum for Worker's Compen.
cation.u pre vidW for by Section 37M of the Labe,Cade.for,IM perfors.of IM
wmk'for which this Permit IS IEaed.
I haw ansa will maintain Worker',Compensation Inmumce.at required by Section
37M a(via IiDm Cade.for we pmfamnnecafthe wok fee which this permit LL T— xi
My Worker's Compenwion In..ams and Policy number mc:
Carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATIONINSURANCE
COnisseulan need not W eonplhh,d if the permit Is(mane hundred dollen($100)
or kis)
l eemifns Nati a Mformamc of IM ark fm which Nis permit h Ls .I Nell mmm
employs, taq n' any manvrwu y��rsmy�u�meW lM Waft Compensation
Laws
or if�m`'�4, 12.Y1 r1 fes/
Applicant 4tli� $42 M01 YA ft
NOTICE IcMI TC NT:If.Our making this CeniOeam of Exemption,you should
become subject N then Worker'.Compensation pro isions a Ne Lesbm Cede you most
.,O forthwith comply with such previsions or Nu permit shall be doomed tevakcd.
z y
CONSTRUCTION LENDING AGENCY
[-+ 1 hereby anIrm that Nen is a construction lending spicy for the PMurmenm of
rL
the work for which this permit Is fated(Sec.309'(,Civ.C.)
W�Q I<mldcr's Name
z Undoes Address
U O I morn that I haw read this appiiaden cad such,than the above thfarmaumm is
Iy ^. cermet I agree in comply with all city and county aNinencet and sum lams missing h,
O rV^ building cmutrunian,and hereby authorin:mp.tatives of Nu city to mmupan do
amili m judgments,
ntopeny fm icapeetion orpswhich ms
0. (We)agree m caw,indemnify and kmP Mrmleu the City or Cupertino agsiv1 . ..
fn liNilitia,)udgmenu,cmLL and upevee which may Nally way acme against aid City
V z AL
flume of Ne grading of this pump.
^ ANf UDERSTANDS AND WILL COMPLY WITH ALL NON-POIINNT Issued byDate r pptt"u TIONS. fur 71 ok Re-roofs
DOUS MATERIALS DISCLOSURE Type Of Roof
Will Ne applicant ar future Wilding mmpulemre orhendle,hsallov mucrind
ss denvd by the Cupertino Municipal Chapter 9.12,and the Health and Safety
Calc,Section 35532(,)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑Na
Will Ne applicam or forum buddi mnio nt use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
hscoudnns air cantaminru u den y the Bay Amst Air Quality Management all new materials for inspection.
District?
❑3!s ON.
I have mad the hantdmm matuish immenu mile,Clupar 6.95 of thin Calif.,.
TILL Ninth&Safety Code.Scoumu 25505,25533 and 25534.1 wticnund NU lfde Wilding
dans My have&some.that it is my responsibility u maty Na aympav of the
req �hh.0 W.tpdarmiavanceafaCutinamar Signature of Applicant Date
Owner 6KudmK7zdascra Dak All roof coverings to be Class'A:*'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT. RECEIPT OPERATOR: patg
COPY # 1
Sec:. Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . .. 31629063 . 00
DATE ISSUED. . . . . . . : 07/28/2008
RECEIPT # . . . . . . . . . : BS000005603
REFERENCE ID # . . . : 08070194
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 . . . . : NELSON B DSOUSA
CONTRACTOR . . . . . . . : YONG B. WON LIC # 30022
COMPANY . . . . . . . . . . : YB CONSTRUCTION
ADDRESS . . . . . . . . . . : 1079.5 MINETTE DR'
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . : (408) 316-1261
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------- ---------- ---------- ---------- ---------- ----------
1BREMRECEP NO. OUTLETS 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1BSEISMICR VALUATION 1, 200 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE 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 122 . 87 0 . 00 122 . 87 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 122 . 87 DISCVR
---------------
TOTAL RECEIPT 122 . 87
•
0107 019
CITY OF CUPERTI
NO
CITY OF
CU
PEIJTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # o (0 , oz) Date: '/2e Q�D�
Building Address: ) 030 D EN S S ON Avc
r_ U►'ERTrND / Ch q50/
Mailing Address (if different from building address):
Owner's Name: Phone#:
ISIELmNk WFA/ .�r SOU2A 4U5s-- syS,6
Contractor: Phone: 4 0$ 3 l — I2
yg Coni s�R u cTrdov C
Fax:
Contractor License#: l8 5-6' ' 9
Cupertino Business License#:
Contact: Phone:
• � � Fax:
Residential Commercial
Job Description: &f, „` 2 II ,y(.. vQs, w, r0ow-4t Fans W/f, n&w dcAtet'
GO KV\elctvo^4 l sW btaxe-� o_S'C.4,-r� Q
SVC a j&C Q4' Z� �jt l VI W']A de cAt e'd SWI, C&eS
3 PVa.ce, tS��n� C11R-fano a� • . ,,,. .
Building Permit Info: — — –
Bldg 0/ Elect t3 — Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
I-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B ❑� 2 '�
Valuation: Square Footage:
!2 f1 D
Project Size: Express �tandard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
to the application or if applicable, include in plan set& the sheet index.
• Points Achieved:
For help, contact Build it Green at www.buildit reen.or
Revised '� 'n
- -ang.
OF
CITY OF CUPERTINO
CUPER,TINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
'Group 1GENRES or
1GENCOM
l BBOILERI For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h•(29.3kw)
1 BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
1 BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1 BBOILER4 Installation/relocation of ea M •
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
IBAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
IELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
1 PLMBINSP Other Plumbing& Gas Inspections P
(per hour •
1MEETINGIHR Application Meeting B
ste., CITY OF CUPERTINO
CITYOF GENERAL BUILDING APPLICATION
CUPEkTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
IFENCE>6FT Non-masonry, over 6 ft in height B
IFENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
IFIREPLMAS Fireplace Masonry B
IFIREPLFAB Fireplace Pre-Fabricated/Metal B
IFLAGPOL>20 Flag pole(over 20 ft in height) B
IMODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1 PILECAST Pile Foundation Cast in place concrete B
I PILEDRIV Pile Foundation Driven(steel,pre- B
stressed concrete
3 of 5
CITY OF CUPERTINO
CITY Of GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONR
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50'
IRETCRB< Gravity/Crib Wall, 0-10'high(up to B
50 R
1RETCRB> Gravity/Crib Wall over 10' high(up to B
50 ft
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1 SIDEST/BK Siding, Stone& Brick Veneer B
(interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 . Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st •
4of5
" - CITY OF CUPERTINO
CITY of GENERAL BUILDING APPLICATION
CUPEkTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description' Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 so B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
I 1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
r
I STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
A 1BSEISMICR Seismic Residential B
/ 1BSEISMICO Seismic Commercial B
1TRAVDOC Travel &Documentation B
1BUSLIC Business License B
S� .r9p cwt k71 C' 5 of 5
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
we
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 IJoist, (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 Refrigerator, (Note/Spec. A-3 1 point
P. Other1 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 Resources Energy IAD/Health
A.Srte
1.Recycle Job Site Construction 6 Demolition Waste
65%=1 point,75%= 2 points;k60%=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 Stonnwater 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 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 0
I 1 1
B.Foundation
1.Incorporate Recycled Flyashin 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=yas 0
3.Insulate Foundation/Slab before bac�ll 3 Energy pts y=yes 0
1 I 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,ointed 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 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
12.Use OSB
a.Subfloors 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0
1 1 1
INPUT ReSDUTCeS Energy IAO/Health
I.Widows
1.Install Energy-Efficient Windows
. a.Double-Paned 1 Energy pt yesesj+0
b.Low-Emissivity(Low-E) 2 Energy pts Y--yes
c.Low.Conductivity Frames 2 Energy pts yeses
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes
J.Heating Ventilation end Air Conditioning 1.Use Duct Mastic on All Duct Joints 71Z/Health
y yes2.Install Ductwork within Conditioned Space y=yes
3.Vent Range Hood to the Outside y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes p
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 31A0/Health pts y=yes p
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 p
13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stovesfinserts 1 IAQ/Health pt y=yes p
b. InstalVReplace 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 p
15.Install High Efficiency Filter 4 IAQ/Health pts y=yes p
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 p
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 18 Energy pts
0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrer 3 Energy pts y=yes p
1
L.Natural Heating and Cooling 1 1
1.Incorporate Passive Solar Heating 5 Energy pts yryes 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 I
x Community Development
10300 Torre Avenue
1 Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
OCUPEkTINO
Building De artment
JOB ADDRESS: 103 DmisoAJ AV5e0-tf?fRVP PERMIT #
OWNER'S NAME: E( SQN PHONE "-'7b
GENERAL CONTRACTOR: p b FAX #
I am not using any subcontractors:
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
Til
er/Con actor Signature to