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08070227 (2) CITY OF CUPERTINO �s�,�� any . BUILDING-DIVISION PERMIT ^EC�FONTRACTORIN 'O , RMATIt01 BUILDING ADDRESS: PERMIT NO. 27096 LINDA VISTA PL DEN-MARK STRUCTURAL 08070227 OWNER'S NAME: PERMIT ISSUE DATE SRI.N.IVASAN 2316 HEARTHSONG CT 07/30/2008 NE: SANITARY NO, CONTROL NO. (209) 727-4144 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 300 LICENSED CONfRACTUR'S DECLARATION O O O O 1 hereby afRsm Nu 1 am lisauW under provisions of Calmer 9(Common Ong Job Description with Section 7")of Division 3 ofthe Business and Professions Code,and my licetae is INSTL CLEANOUT s in full forte and cffecL :,n— Liceve Class Lk.If n; Dow comruur, ARCHITECTS stDECLARATION V I underand my plans he used as public records IC u oll n•t; Licensed Professional SD5 OWNER-BUILDER DECLARATION MI hereby sifter,that I am cacmnNe pt from the Conlraoel License law for no following¢son.(Section 711313,Business and Professions Code:Any city of county $ which requires a permit I....."OL alter,improve,domnlLN,ar wbput,any met.. _zy prior to is issuance.aso requites Weapplicator for such permit to file a signed sacmcnt pmmC that he u licensed pursuant to the provisions of the Cmuactars Lice.Law(Chapter 9 Sq.Ft. Floor Area Valuation yFg (comer nciagwithSmc on7ODO)dDivision3ofOeBusinessendPmfessiomCode)ur $1000 .- Nat he u eaempt therefrom and the basis for the alleged exemption.Any violation of Section 703M by awry applicant for a Permit mbjcros the applicant be a Civil penalty of ppN Number Occupancy oat mare Nen five hundred dellen(S500). 35608008 .'U(7' P y Type 0 I,u ownm of He pmpmy.m my employeex with veru u Neo sole compenvdon, will doleworll-arta Na as Coreunort LMede Lawdo does Out of Required Inspections and property who ns Cade:The Cementer',and who law don wort apply Wan owner of q P race employ .providsor impmvas such woo aresninten edrk oropfer forseehrough hu race Natsueb impsmemenuartnet intended OreBered the Owner. ' border the have t1 g u rcen of ernuout proving that within mre year or sample forn.He awe of r. builder will bw Ne burden or proving Nat M did oat build or improv for purpose of u—th.I/. 50.as owner of the property,am exclusively ccouaclut with licensed cnnuactms W contract the project(Sec.7010,Business am Professions Code:)The Commmer's U. . Ounce Law does not apply W an nower of propcny who Wilds or improve thereon and who Contracts(orsuch projects with a eonuacauds)licensed pursuant W He ConuanaYa License Law. ❑I am emunp,under See ,B&PaC-rfm1,N.,u wron Owns am WORKERS �— COMPENSATION DECLARATION 1 hereby alliin under Por EY or PCr3my was of the following decbratim¢ 1 have and will mahout.a CeW ote or Consent W selfAnswe for W.rk.ls Compen- sation,u Provided for by Section 3700 Of the labor Code.for the pert rmamen of the wart fm which Nis permit is oseC& ❑1 have and will maintain Worker's Compensation Insurance,as squired by Section 3700 of Ne Labor Codo,for the perfournmee or Ute work forwhich Nis permit is issOud, My Woriwe,Compensation bamance carrier and policy r u rh are: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need Out N completed ifft Permit is ferone hundred dollars(1100) or less.) I certify Out to Ne perfam once of the worts for which this permit is issued,I Nall out employ anyperam in any anG= sa ' t W the Workers'Compensation laws of Califomia.Date Appli., NOTICE TO APPLICANT:If.after making Nis Certificate of Eace prion.Jon stfould become subject W the Worker's Compensation provisions of the Labs Code,you muss .J O forthwith comply with such provisions or Nis Permit shall W deemed motrd. Z�y CONSTRUCnON LENDING AGENCY [-� 1 hereby affirm than Nem is a Consauctino lending agency for the perform.of FL the work for which this Permit s Owned(see 3097,Civ,C.) Q Lender's Name . .7 z lenw lender's Add U Q 1 certify that I haw read this application send saw but the shove information is "4 F conZn41 agree to comply with el city and county Ordinances and raw laws relating W C V building construction.and hemby sutberire mprtxnatwa of Nu city W enter upon tho aboiIh1=j onedproperty for inspection pur,owhich a �•n y s. (We)agree to save,indemnify and trep harmless the city of Cupertino against to incoiticcuenc of the oss cad espmsmrwhtch may in my way accrue against said City O,z A APPLICANT or Negranting of Nu permit ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGU ONS. C,Igo I6y� /Signature of App4CwwC,wwwcter DUO Re-roofs �y HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will dor applicant or future Wilding=upset rWre m handle haurdou material as dented the Cupertino Municipal Code. Chapter 9.11.and the Health and safety Code.Sectio.n 25532U)? ❑Yas Ej`N. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building a=cupmt use equipment or devisee which If a roof is installed without first obtaining an inspection,I agree to remove it hanrdnu air concomitants as defined by He Bay Arta Air Quality Management all new materials for inspection. suia? ❑Yes P I have rad the hamdous materials requimmems umk:r Chapter 6.95 of the Calle. ria Health&Secty COde,Sodom 23505,25533 and 530.1 umicaund that if Ne building does net curantly haw a..4that it it my responsibility W udfy the a¢s am of site requirements Wbl an bellletpriorwasuuce.faeenifte,Wy[OF Signature of Applicant Date /g�Vgl / II 0 0 All roof coverings tbCl s o e ass'{. Owner or autherisd ss=nt ate' g a'OC better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: pdtg COPY # 1 Sec : Twp: Rng: Sub: B1k: Lot: . APN . . . . . . . . . 35608008 .00' DATE ISSUED. . . . . . . : 07/30/2008 RECEIPT # . . . . . . . . . : BS000005638 REFERENCE ID # . . . : 08070227 SITE ADDRESS . . . . . : 22096 LINDA VISTA PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SRINIVASAN ADDRESS . . . . . . . . . . : 22096 LINDA VISTA DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4022 RECEIVED FROM . . . . : TIRUVALI S SRINIVAS CONTRACTOR . . . . . . . : MARK DAVIDSON LIC # 30008 COMPANY DEN-MARK STRUCTURAL ADDRESS . . . . . . . . . . : 2316 HEARTHSONG CT CITY/STATE/ZIP . . . : RIVERBANK, CA 95367 TELEPHONE (209) 727-4144 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 1, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1PRSEWER UNITS 1 . 00 20 . 40 0 . 00 20 .40 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 102 . 48 0 . 00 102 .48 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 102 .48 #1179 --------------- TOTAL RECEIPT 102 . 48 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 400 SEWER/LATERAL , 507 FINAL PLUMBING 6)d0-70-�:2 7 , CITY OF CUPERTINO m REPIPE/SEWER/MAIN SERVICE CITY OF . CUPERTINO PERMIT APPLICATION FORM APN #22 U ,\ �l Date: Building Address: 22b96 Llv\aR Y f Gtu / CkTQJTtiIna CV q !91 f. Owner's Namet1 �V J t1 S • SSI N1\J fps k Phone #: 4t 8- -�Z3 Contractor: Phone #: Zp 1 606 6 2+7 K KPIC ST"CTU Fax #: Contact: u 1 ftlzy- D H `D S 0t\J Phone#: ' L Fax #: Contractor License#: t-2-& 1 LZ Cupertino Business License #: Job Description:. C-�Q"0-U Residential [� Commercial ❑ Valuation: r©©0� Project Size: Express tandard 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 IPGASCOM Commercial Gas Piping System P 1-4 Outlets 1BSEISMICOM Seismic Commercial p • r 1BSEISMICR Seismic Residential p 1 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 1RPRP 1BPWSVCS Water Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1BPWATER Install/alter Water Pipe P IBPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets 1BPGAS Gas Piping System 5+ Outlets P 1 PPERMITFEE Plumbing Permit Fee Issuance P 1PLMBLNCK Plumbing Plan Check P • IPLMBINSP Other Plumbing/gas Insp. P 1TRAVDOC Travel &Documentation Fee B 1BUSLIC 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 z. B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points 11. Permeable Pavin Note L-1 2 oints C. Foundation 1. Use 15.% Flyash Concrete, (note) S-1 5 points D. Structural 3. Uses Wood 1-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/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 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. A.Site INPUT ReSDUTCeS Energy A011-lealth 1.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 8 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 8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0 9.Reuse MaterialsrUse 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 1 1 B.Foundation 1.Incorporate Recycled Flyash in Concrete 25%Recycled Ryash=2 points;Add 1 point for every 10% • increase of flyash,up to 5 points up to 5 Resource pts D 2.Use Recycled Content Aggregate 2 Resource pts y=yes 0 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 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]-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 S.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0 9.Use Structural Insulated Panels(SIPS) a.Floors 3 Energy pis 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 i Resource pt y=yes 0 b.Sheathing 1 Resource pt Y_—Yes 0 • INPUT ResDurces Energy I.Win 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 Y--yes 0 2.Install Low Heat Transmission Glazing 1 Energy pt y=yes D 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=yes D 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 3 IAO/Health pts y=yes 0 b.Water Heaters 31AQ/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 stoves inserts 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 31AQ/Heallh pts y=yes p 1 K.Renewable Energy and Roofing 1 I 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 6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0 7.Install Radiant Barrier 3 Energy pts y=yes 0 L.Natural Heating and Cooling 1 1 1 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 • 1 1 1 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 IfUPEkTINO Building Department JOB ADDRESS: 22og6 t_I N DR l l5.1k ?UfttE PERMIT # OWNER'S NAME: «J k(-1 S• PHONE # 2 6 ef— GENERAL CONTRACTOR:DEN FAX # I am not using any subcontractors: -T �;,o o� 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