08060239 (2) ' CITY OF CUPERTINO
BUILDING DIVISION ERMIT ��NTRACTORI1 '� t�V1ATI(:)N :3
MIT NO.
BulLglyca3A9V'1"INDSAY AVE AMERICAN RESIDENTIAL P�08060239
OWNER'S NAME: SERVI"5 UF PERMIT ISSUE DATE
SANJAY KRISHNAMURTHY 5100 POPLAR AVE STE 3000 06/27/2008
ONE: SANITARY NO. CONTROL NO.
ARCHITECVENGINEER: BUILDING PERMIT INFO
NEED TO INSTALL PROPERTY BLEG EO PLUMBMECH
eOp LICENSED CONTRACTOR'S DECLARATION
ho u 1 hereby affirm Nn Job De$CilIIOn 1 am licensed under provisions of Chapter 9(commencing ^^••^^ ^^^ P
with Section]IXXn.fDivision Sof Nc Butiness and Pr.fcuiom C.de.arld myliccnxu
a in Full fame and effect I T fit'
q z License Class Lic.• .
Date ham. R7 Contrxrar g1'
eRCHTIECTS DECLARATION
y W U 1 undersand my plans shall be used as public records
gra
G G Lurnad professional
OWNER-BUILDER DECLARATION
<f 1 hcrthy aRnn Nal i am.Bump,from the Contractor's License,law for the
OO following mason.(Section]0l L3,Business and Pmfessians Code::Any c city or aunty
I$�i which require)a Permit m cnxmet.alter.Improve.demolish,or repair any mrocare
L i y prior in its issuance.also requires the applicant for such permit to rile a signed statement
EFG
thall M a licensed pursuant m the provisionn;of the Contractor's Licturtac Law(Chapter 9 Sq.Ft. Floor Area Valuation
+� $ (cwnmcncingwiNSttuon7000)of Divuion3ofthc Buin=udProfessionsCode)ur
s — Nat ha Is exempt therefrom and the basis for the alleged exmption.Any violation of
Section 7031.5 by my applicant for a parent,subjects the applicant to a civil penalty of APN Number Occupancy Type
not am Nan Rn hundred dollars($500). P Y YP
Luoancrof0ieprose ctummnotinmy dor. cmdrssthelrmleca ..Bunn,
will do thework ands:The Con Is turas License
Law
do Fu of apply 70th,owniws
and property
W cads:The c.naacmrr and
Law doe,not apply m an owner is Required Inspections
property who builds vi ire prows titereom and who dao such work himself.r through bf
cram employers,provided prover improvements taemyear daul a(cmo@ted fm sale If,
hawesrr,Ne building ha Impromncnn u sold within ora year ter completion,the oana-
builder will hon the buNus of proving that he did ton btuW or improve for puryose of '
❑1.u.wver of the papery,son exclusivelymerand
conoaping with I)The C nua toes U.
mal I I
coutroet the es not (Sec.o an c Business rop rty who
Cade:)The Cana mus.Lid �IV/
cense law alma not apply m is owner of property who Guilds m unprosra Nereus.and /i/ /V
whocontactsfor such pmjcca wiNamnaacmRs)Iimnxd pursuantmttr Convacmrs /r
'I �I
L'setase law.
❑lam ucmpt under See .Ba PCfar this main � I
wncr
Data
WORKER'S COMPENSATION DECLARATION
1 hereby Lffi m under penalty of perjury am of Lha fallowing declarations:
❑1 have and will maintain a Cardinal&of Consent to self-insure for Workers Compen-
sation,u provided for by Section 3700 of the labor Code,fm Ne performance of the
work for which this permit is issmd.
I]1 bare and will maintain Workers Compensation luurance,as myubed by Section
3700.1'the Lamm Code,fm the peRarmanec of the work forwhich this pexit is ivad. '
My Werkeies Compo pfinua Laurance artier and Policy number an- D i^
Camicr.FOCX10lL CO/df*'eFPolic Na.:4c-7DJI'5b$'- s I'O17
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
This seeder need not be com plead aft permit Is fm one hundred dollars($100)
or less)
I certify that in than performance of the work fm which this Permit is issmd.l;balm not
employ any person in any manner an as to become subject o the Worsen'Comp ssesion .
Laws of Califomia.Data
A111ML
NOTICE TO APPLICANT:If,after mating this Cenificaa of Exemption,you should
become muca to the Worters Compensation previsions of the Lahr Code,you mum
.,O forthwith comply with such provision or this permit shall be deemed revoked,
55 CONSTRUCTION LENDING AGENCY
F k for
rwhichithi that thea isacommutation 30 len ding agency for ft peruxance of
theLs work for which this permit u ivmd(Sec.7(19'1,Civ,C.)
W� Isndcrs Nanc
jz Lenders Add=
U Q I Certify Nat I have mad tMs appliem.n aha sal&that the above informadun u
W F conrecL I ago in"reply with all city and county oNinamer and soon laws rtlaung to
0U building consuuc,i.n,W hereby auNorissreprewmutires of Nis city to enter upon 0te
yabove-enenuoncd property for ex enses purposes
(We)ages,he sun.Indemnify and kelp lameleas NC City at Cuperina!Rahe,
Z incoisce.Judgmenu.easusou.,expenses which may in any way acmuc agaiulseitl Cl,y
t.),Z A consequence of the Ranting of Nu legit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 6
SOURY/R UTATL I9 -
Y Re-roofs
SigaRma.f Applican✓Conuator peon
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will th,appliant or fu,wc building oaupar tam or handle huudou material
as&Read by the Cupertino Municipal Cade.Chapter 9.13.and the Health and Safety
ode,
Section 15533(,)? All roofs shall be inspected prior to any roofing material being installed.
Yon o
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant or uwm building.ccupant use cyuipmentmdcvicea which P g
emit harudnu air contaminants as defimd by Ne Bay Area Air Quality Management all new materials for inspection.
Distric,7 P
❑You
I ban mai he haundl materodsreyviamenu underChapterh.95 ofd.Califs.
nu Health&Safety Code.Sceuats 15505.75533 am115536.1 undrnwA dtu if No building
does tet currently have a tenant the,it u my tW.tatlbility be mufy the occupant of the
ageimme,rts_ n�Pnmx metpdmthiaumee.facertlr sofa Signature of Applicant Date
V � G�7•o��
Owncr or m,harimd agent D,mn' All roof coverings to be Class also,or better t
Community Development
J 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
,, 8
CITY OF Fax(408)777-3333
SCUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
d(S-C7 K0Z3
OWNER'S NAME: SR N K2iS NAIA minim PHONE # g• 619 -,Z56 )
GENERAL CONTRACTOR e Egat r, eoo?' FAX #
I am not using any subcontractors: 7/� �—��— 6 �'O�
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 —,;;,6 51 SS
Roofing
Septic Tank
Sheet Metal
Sheet Rock
• Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36912011 . 00
DATE ISSUED. . . . . . . : 06/27/2008
RECEIPT # . . . . . . . . . : BS000005281
REFERENCE ID # . . . : 08060239
SITE ADDRESS . . . . . : 10369 LINDSAY AVE
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SANJAY KRISHNAMURTHY
ADDRESS . . . . . . . . . . : 10369 LINDSAY AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4517
RECEIVED FROM . . . . : AMERICAN RES. SERVI
CONTRACTOR . . . . . . . : DONALD KARNES LIC # 21504
COMPANY AMERICAN RESIDENTIAL SERVICES
ADDRESS 5100 POPLAR AVE STE 3000
CITY/STATE/ZIP . . . : MEMPHIS, TN 38137 '
TELEPHONE . . . . . . . . : (4 08) 982-0405
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ --------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 300 . 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
1TRAVD0C 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 8128004659
---------------
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
•
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
• CUPERTINO PERMIT APPLICATION FORM
n� eP D��3
APN #�� Date: �.. (ye OO
Building Address:
1x36 NDSA AVE , Cupcie-riAo , 94014
Owner's Name: Pho e #:
SAA) kKiSklAtAMu,2TN - . -/,9 . 2 1
Contractor: Phone
eE-swt� foo-rE-e PcuM61'NCT- Fax #:?2' 409. 9e2- 04o9 (sKoP
Contact: Phone #: 'YO2_ 266-76.2
�/ 1/JCC�''r l OCjels Fax #:
Contractor License#: `76 .5 155
Cupertino Business License #: Z 1 $p4-
JobDescription: -VA15-0�4,LRO E2T
�jP � � � �%�� C�FAnlou
O/J MA 1 N SCzJ� Z A—Tr
�L
Residential b(V Commercial ❑
Valuation: ('
Project Size: Express ®--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 Building Points:
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
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial p
r 1BSEISMICR Seismic Residential P
I 1PRSEWER Residential building P IRPSS
sewer/sanitary sewer
CITY OF CUPERTINO
` REPIPE/SEWER/MAIN SERVICE
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Grou
IPRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
IR-PWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
113PWATER Install/alter Water Pipe P
113PFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
1PPERMITFEE 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
n.
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/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
a TOTAL POINTS1 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 AQ111ealth
A.Site
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&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 Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pis 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 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]-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
12.Use OSB
a.Subfloors 1 Resource pt y=yes 0 •
b.Sheathing 1 Resource pt y=yes 0
1 1
INPUT Resources Energy
I.Wm 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 i Energy pt y=yes p
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts y=yes p
2.Install Ductwork within Conditioned Space 3 Energy pts Y--Yes 0
3.Vent Range Hood to the Outside 1.IAO/Health pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7
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 p
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/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 p
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y--yes p
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
• 13.Retrofit Wood Buming Fireplaces
a.Install EPA certified wood stovesfinserts
1 IAQ/Health pt y=yes p
b. Install/Replace Dampers 1 Energy pt y=yes p
c.Install Airtight Doors 1 Energy pt y=yes p
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(HAV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes p
1 1 1
IC 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 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 p
I 1 I
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes 0
p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
• 1 1 1
' FROM':CUPERTINOSANITARYDISTRICT FAX NO. :4082535173 Jul. 03 2008 03:21PM P1
• DISTRICT MANAGER.ENGINEER �`�0 SANlr4#j.
��� �J� BOARD OF DIRECTORS
MARK THOMAS A C MPANV,INC,
RICHARD K.TANAK WILLIAM A.BOSWORTH
JOHN M.GATrO
DISTRICT COUNSEL YEAR$O F CURT13 B.HARRISON
SF.AV1_E
ATKINIION FARAe ,LLP. �fAs�Ia NKS *~w WENDELL H.KERN,JR.
HAROLD e.TOFFEE CHRISTOPHER C.LEE
201193 STEVENS CREEK BOULEVARD,SUITE 104
CUPERTINO,CALIFORNIA 95014-2104
(408)2837071 PHONE . (408)2536173 FAX
www.CUP9rtin0sanitaryd1Strict.Com
File: Cu,9D—MOP
Building Dept. —Cupertino
I
City of Cupertino
Attn.; Building De artment
103 j
10300'I'orre Ave.
Cupertino, CA 950 4-3202
Subject: SP'D.insta 1 Property Line Clean-out
• Name: Krishnamu by Residence
Address: 10369 Li dsay Ave
APN: 369-12-300
Permit No. 080602 9
Videotape nd Property Line Cleanout inspected.
No addit onal conditions/requirements by the District
Inspector: eorge Santos/Roger Santeg.... � �"' ----
Date:...02- 8-2008.... I,;1�•� ....................................
Sanitary Steer Location•
8' R/Pl,
cc: Property er 23' .Long
5' Deep
S:\WORDS\CUSD\ XI TERS\BUILDING DEPT LETTERS\CuSD 2008_TV
Inpection_0806023 -10369 Lindsay Ave-07-03-2008,doc
SUPPLYING SANIRARY SEWS GE SERVICES FOR:CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND
SURROUNDING UNINCORPORATED AREAS
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