08080056 (2) CITY OF CUPERTINO
BUILDtNG'DlvlslpN PERMIT C�NCRACTURII ORMATI¢N
BUILDING ADDRESS: PERMIT NO.
1051.8 MC CLELLAN PL WATER HEATERS ONLY 08080056
OWNER'S NAME: PERMIT ISSUE DATE
X,:IAN XU 970 E MAIN ST 08/07/2008
E: SANITARY NO. CONTROL NO.
(800) 835-5946
ARCHTIECT/ENGINEER: BUILDING PERMIT INFO
'BLDG ELECT PLUMB MECH
Sop LICENSED CONTRACTOR'S DECLARATION IbD Description
rd LZ'+F I Mehl,ham Nu
r1 are licensed under provisions of Chapter 9 instrumenting SCTIP
mentin{
< with Section 71)[113)of Division 3 of do Business goal Professions,Code,rad my liceneis RPLC WTR HTR 50 GAL GAS
eg in full force and r'ff ?� J-7
j 3 Lkenrc Cl Lt. 0got
Ce i l Caner ECL ARC a OEC A l N
I understand my piens shall k u"d"public records
DyU
{god
Licensed Pmfcuionel
5 Oat I go� ctrul fr DECLARATION
C<0 I hereby aso .(Rue on I I.S.uampt from Ne CoavanCo s:My c Iso for IM
i O 4 fallowing reason.(Solan 763 LBusiness and Professions Cods:My city s .num
9
which rtyussu a pemo re cores the appliaftes.cant,
impmsu dPermit t.or repair any mum
_Z< pdarbits issusnce,sisurt W due Provisions
spionso for such Permit to NeasLaw(tsgemem
C than mencinmeWpur"sntta0MofDivision
isiomeolof ftBuinessaJanscssiouGopger9 Sq.FL Floor Area Valuation
(cat M It
(commencing with Sratian T and
the
Div is for t f Ne Business and on.Any
vi Cade)or $895 .
$ Net io r 1.5 b IM appli and Ne aper it Ne silaad occupation.AnY violgolm of
not on NO0an fay gory red dont Its•permit subjects to applkanup a civil penalty of Number Occupancy Type
not mare Nan Rw hundred dollars($SW). 3 5 9 2 0 0 3 7 .tT o
I,u owner of Ne property,car my employes,wIN wags u their ant campenssJon,
will do Newark,and Neswctum isnrtinhoded oraRned tarsals(Sen.7044,Business Required Inspections
and Professions n
code:The Comcmroo e ns
r's License Law does t apply an owner of q P
property who WildaorimprowxthertoR end who does such work himselfwthrough his
awemploYees,provided Net such improvements pee not Low oroRertd fmule If.
howcwr,Ne Wilding or improvemant r sold within oro Year of c umpktm.the aw.cr.
Wilder NB haw do harden of proving that he did not Wild or impraw for puma¢of
"ICJ.
❑1.as owner of to prope.Y•am exclusively contracting with Ikensed ronuanan to
mas et t e pink"(Sec.71304,Business and Profusions Code:)The Congruence.U.
comes Law does not apply be an owner of property who Wilds or Improves thereon.and,
who counties,for such projects wit r conuator(s)licensed puaevart w the Commas or's'
License Law.
❑Iamexemptunder See .03PCfor Nroaann
Owner Dam
WORKERS COMPENSATION DECLARATION
1 beraby arm under penalty of perjury ao of than following declargolmsc
1 haw am"I mainuia a CortlRam ofCauent in self4rumm for Workees Copper,
wldr.as provided for by Sada.37W of sin:Labor Cade.tour t o Performance of the
wart for which Nr permit is rued.
❑1 have and will maintain Worker's Compensation Insurance,as mqui nd by Scott
37W of t e LlWr Code,for dm Performance alto work for which this pemll is issued.
My Wor pensW�an�l/q"�m.��.�K(ayr'�ar and Polley number art:
Cud r. m fr-G/ppliq Na.: motor
E 1ICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This seNm need not uncompleted Ifto permit is forage hundred dollars;($100)
or less)
1 ceN fy dust in the Mr...of the work for which this permit Is Wued.l"I oat
employ any perm.in any mamoras as m Moan.subject m the Warren'Campemadon
Laws of Califomia.Data
Applicant
NOTICE TO APPLICANT:If,after making this CertiRcao of Esempdon,you should
become subject Is to Woraees Compemekdag previsions of to Mbar Code,you most
0 O forthwith comply wit such provisions or Nie Permit shall k deemed revoked.
z ^' CONSTRUCTION LENDING AGENCY
[-t IMmby.ML. u omisacom lankndingapxyfwftrerfwm of
Ci
the wart for which this permit Is issued(Sen.3091,Civ.C)
A Lerdefs Name
D z Leanne.Address
U 01 modify Nat I have read Nis applicadm and stage Nn the amove information r
LL`V cormcL I yrs o comply ..,�.ply with all city and country mul auction aw ge lrelating o
0 Wilding construction.and thereby auumdn:mpremntstives of Nis city to erten upon the
[i] aWve-os,ntionad property for inspantm pugm"a
W (We)agree to an.indemnify and kap harmless,the City of Cvpesin0 against
„y y liabilities,Judgments.costs and expenses which may In any way acrne against said City
V AI con ucroe of Ne granting of Nis permits
AP I ANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
$ REDULA NS. OQ
—D-O ir Re-roofs �--
Signsum of Mm ian1 Conmclw Dam
HAZARDOUS MATERIALS CLOSURE Type Of Roof
Will do applicant car forum Wilding aavpantsmre m handle heraNans mamdsi
as declined by than Cupenina Municipal Code.Chapter 9.13.and to Health and Safety
coda, [:]res.as32ar. All roofs shall be inspected prior to any roofing material being installed.
von
to applicant or
s
❑ ure Wilding doeupam on equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
sit ha'rsrdnw air conominanm"dclin al by NC Bay Area Air Quality Management all new materials for inspection.
u TIT
❑Yes /
I have read site hasallous materials requvenorme walerLTeptwd.95of NC Cslifw.
NaHcal"Safray Cade Scmk=25505.25533nu135534.IwWd vend Nm ENe Wilding Q
Jon porTnimently have a gentograk14my responsibility m IotfY Nc occupant,of the
t
req whkhmua pioro' ofaCenifiamof Signature of Applicant Date
owner'ae.amad e g st All roof coven s to Class'W'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35920037 . 00
DATE ISSUED. . . . . . . : 08/07/2008
RECEIPT # . . . . . . . . . : BS000005720
REFERENCE ID # . . . : 08080056
SITE ADDRESS . . . . . : 10518 MC CLELLAN PL
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : XIAN XU
ADDRESS . . . . . . . . . . : 10518 MC CLELLAN PL
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : MCGEE, PAT LIC # 18986
COMPANY . . . . . . . . . . : WATER HEATERS ONLY
ADDRESS . . . . . . . . . . : 970 E MAIN ST
CITY/STATE/ZIP . . . : GRASS VALLEY, CA 95945
TELEPHONE . . . . . . . . : (800) 835-5946
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 895 . 00 0 . 50 0 . 00 0 . 50 0 . 00
I.PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 . 48 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 106 . 56 MC
---------------
TOTAL RECEIPT 106 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- --------------------------- . . `------- ----------------------------
57.8 WATER HEATER
U
CITY OF CUPERTINO
Q� WATER HEATER
0 OF
CUPERTINO PERMIT APPLICATION FORM
APN # Date:
Building Address:
Owner's Name: Phone #:
X'/AA/ X C) 0 f 7Z,�- �7z
Contract/or: / / .-yam Phone #: .
C. Fax #:
Cupertino Business License #: Contractor State License #:
Contact: Phone #: 5--.3 v- 2 ;7 Y- ,So, j
� ' 7�f
Fax #: s-o 6;2v�
Building Permit Info:
Bldg ❑ Elect ❑ Plumb Mech ❑
Residential Commercial ❑
Job Description:
Q� 14Le I-lea-le� s� l G<-
Strapped On Platform ❑ Bonded ❑ New Location ❑ Replacement
Valuation (cost of project): ^-S-
Project
gSProject 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 judex.
Green Buildin Points achieved: .3
Revised 6/16/08
CITY OF CUPERTINO
allp WATER HEATER
CUPERTINO PERMIT APPLICATION FORM •
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
HeaterNent
1BSEISMICOM Seismic Commercial B
1PRWHEATR Residential Water B PRWHEATR
HeaterNent
1BSEISMICRE Seismic Residential B
1PPERMITFEE Plumbing Permit P
1 TRAVDOC Travel & B
Documentation
1 BUSLIC Business License B
/co 5-" 8 /41e C le 4.1
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 as below
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 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
V
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 ReSOUTCeS EneTgy IAD/Health
ite
1.Recycle Job Site Construction&'Demolition Waste:
65%=1 point;75%= 2 points;60%=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 pis 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 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 Flyashin Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10%
t . increase of Flyash,up to 5 points up to 5 Resource pts0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundatbn/Slab before backfill 3 Energy pts y=yes 0
Em1
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 Heals 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.Well 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
t2.Use OSB
a.Subfloors 1 Resource pt y=yris 0
• b.Sheathing 1 Resource pt y=yes 0
1 1
1
n owe
1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt yryes 0
b.Low-Emissivity(Low-E) 2 Energy pts yryes 0
c.Low.Conductivity Frames 2 Energy pts yryes 0
2.Install Low Heat Transmission Glazing 1 Energy pt yryes 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pis y--yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts Y--yes 0
3.Vent Range Hood to the Outside 1 IA01/Heallh pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts yryes 0
5.Install Solar Attic Fan 2 Energy pts yryes 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 3 IAQ/Health pts y--yes 0
,byv'ater Heaters 3 IAQ/Health pts y--yes 0
9.Replace Wall-Mounted Electdc and Gas Heaters with
Through-the-Well 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 yryes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts yryes 0
13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoveslinserts 1 IAQ/Health pt y=yes 0 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/Health pts yryes 0
1 1 1
IG Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts yryes 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,3.8 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials i Resource pt y=yes 0
7.Install Radiant Banner 3 Energy pts y=yes 0
1 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 pis Y--yes 0
1 1 1
rr r,^— � n.G:. .� -n. ..r. ... ... .-'+• .rte— - .. -� _ �. ..
Community Development
10300 Torre Avenue
-to Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
16UPEf�TINO
Building Department
JOB ADDRESS: PERMIT #
/05-,-8 /tee CI��QK F/ of
OWNER'S NAME: 1,,r4x) xu PHONE # 7,7,!;--- Q7Z 9
GENERAL CONTRACTOR: Wq,4e! esters „ l FAX #
I am not using any subcontractors: (.,r. AM4C 9-J12=?49�Z?
SignatuYe 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
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contra or S ature Date