08070087 (2)CITY OF CUPERTINO17
PERMIT
.f4w� -'` *`i ^� "
CONTRA TQR ITV' URMATIE3N�
BUILDING DIVICION
emLpltic,3p17R M
PERMIT NO.
ERRITT DR
bNAbM7E:
CALIFORNIA SKYLIGHTS
08070087
OWNER'S
PERMIT ISSUE DATE
VERONICA LAM
2250C PARAGON DR
07/14/2008
E:
SANITARY NO. CONTROL NO.
IF •
(408)865-6759 "'
ARCH17SUIENGINEER:
BUILDING PERMIT INrO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
Chapin 9
Job Description
P
1 hmeby arfim that 1 am licensed under provisions Of (cro murrina
wiNSecdon]OOU)ofDiAs n3oftmBatinmudProfcssiumCOde,a mylkenser
PGRAD SVC PANL FRM 100 TO 200 AMP
in full tura ane effen
License CI a Lk. g
Dam Con�rxsy
ARt T10N (•
ibc;;c P
�nJ my plate shallbc uxd as public mcnNa
mm�K
LNcnseJ PmTision
DECLARATION
OWNFR-6UILDERform
1 hmanu olBm Net I am trump from the License Law for the,
ssiomCContractors
moron. (Sedan 703 LS, Business and Cade: Any city or county
vefcssmm
which requires a Permit le construct, alms Wpmve, fie any awcwrt
which re
h permit
oineluse ranpro applkNf the Con pCl11 '$ Liconse Lae( Cammepl
he its licensed e. a sig
mat toiviam of the (Chapter 9
700(1)9Division
Sq. Ft. Floor Area
Valuation
pursuant
that mcit panuont
of the Burl... d Profaoinm Code) Or
(commencing with Section Div Code)
(cat
$28 0 0
I he i,ng
and the is for
that io u ewnpt therefrom the bur for the alkgetl eamptam Any of
mind
l Penalty
Section any applicantran permit subjects the applicator to Advil penalty of
31635004. Number
Occupancy e
P Y�'P
mat mart tb>o Tiro hundrtd dollar (SSW}
done five
❑ L u owrcr o mac wllh wee ale'u wk compcmukn,
.the thamuc,
will dothashoes and We,w C mrnotkmos ooRc do forsok(See.to44, Buionv
m intended dfor
and Code TW Camm�ora law dao ml apply lf
oaMb
Required Inspections
ni¢rt¢
through his
lobe b�ar,oimpmw, rt is
arty wh bu docaet
I.-, Oroffred
own em hhoprandrobe
impo
cer foeed, R.
Of coroQesal
thoWIpmddetlthusuch
however, the Wilding orimpm emraltraal IsarofcwvPkdoortlmowrcr-
Warmer. sold isnot
he set
Wilder will low the burro of poling Wt W did rot W31tl o improv for purpose of
-
❑ 1. as Owner of tm property. and exclusively contracting with licensed mmacsas to
mmwcr the Project (Sec. 7D.4, Business am Pro eacom Code:) The Contractor's Li,
Omanlaw docs not apply to an owner, of property who Wilds or rdprows threcon, and.
.
wWro ash pojems wiNarnnuxlor(s)Iianzd pursuanttodu Cornracmis
Law.
law.
E] lase
❑Ion trumpet untler See .BRPCfo thisreawn
..
Ownm Dam
WORKER'S COMPENSATION DECLARATION
I hereby,rBm under Penalty of perjury one or the following deelaeatiom:
1 haw and will maintain a Certificate a0matem to self-insure for Wm exComport.
smien, as provided for by Section 37W of the Labor Code, for the Performance of to
mark for which this pcmit is issued.
0 1 haw and will mainland Workcrk Compnaado. Imurence, as acquired by Smeon
37WoflW Labe Cede, for the pr(omaace of the work for which thisp.it I, issued.
'
My Warkefa Compensation Women artier and policy number are: C�
Carrier. '/Y l7sa`Y bS Policy No.: / 7% I T
CERTIFICATE OF EXEMPTION FROM WORKERS'
STr4%E ,Q,,�ACOMPENSATION INSURANCE
Mals semlon need ona be complamd athe petit i, foap to ndrtd dollen (sio0)
or leu)
I certify that in the pvromance Of tW work fm which this permit is issued. ) slail rot
c.TPlay any perp. In an, ma11Mr as as to bccounc subject to the Wmlacrs' Carepemadaa
Laws of Califomia Dam
APpEant
NOTICE TO APPLICANT: If. after making this Cc tifsate of Exemption. you Nauld
become subipt m the Wcrku'a Compmation Previsions of the labor Cade- you most
roMwith comply with such pmvitloru Or this petit Nall W deemed! evened.
CONSTRUCTION LENDING AGENCY
1 bemby affirm thu Vert I.. cem usom. lending agency for the prromance a
the work for whim this permit Is issued (Sec- 3097, Civ, C-)
Under, Nam:
Lcodefe Addmas
I certify that I baro mad W, application and sum tan the aWw information r
comm 1 Agra Le comply with all city and county o dmances and sou laws relating to
Wilding comm action, and hereby aushar m rtprtsenuuws of this city to now upon tW
above-mentioned property for impection purposes
(We) agree to acro, indemnify and keep homeless We City of Cupnino Maim,
liabilites, judgment, costs and expenses which may in any way accrue Maim, said Cy
in consequence of the granting or this panic
APPLICANT UNDERSTANDS AND WILL MPLY WITH ALL NON-POINT
SOUkCE$EOULATIONS. /
Issued by; Date r�
. q
Re-roofs
ahgamsre ofApplinn nuacmr 77 , Date
H RDGus hy1'rER1ALs DISCLOSURE
Type of Roof
Will dm apPliant o forum Wi ding Oceupant some or, budk haurdom material
as defined by ton Cupnihm Municipal Code. Chapter 9. 12. and the Health and Safely
Cale. OYoaon 23532(x)? ISNa
All roofs,shall be inspected prior to any roofing material being installed.
Will the applicant or future Wilding occupant use crhmpmeel Or devices which
If a roof is installed without first obtaining an inspection, I agree to remove
emit h-smims air canlamimmLS as dicimaE by the Bay Area Air Quality Management
all new materials for inspection.
District?
❑Yon No
I here mad the Nramos s materials rtgairmem munder Chapter 6.95 ofthe Califor.
err Real"SafetyCodc. Soctio s 25505.25533 and 25534.1 utdaawd Ns, it the pudding
'
don tot cumndy have ofit. thu it es my mspmibilih tiry tc asupanl of the
mgeirtNnwn Wmelparmssa Ra araT
e
Signature of Applicant Date
All roof coverings to be Class 'n' or better ,
owne,mmthmined.gem Dam'
• 3 ITEMS OF 3
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 31635004.00
DATE ISSUED.......: 07/14/2008 --
RECEIPT #.........: BS000005456
REFERENCE ID # ...: 08070087
SITE ADDRESS .....: 19665 MERRITT DR
SUBDIVISION .......
CITY CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT
0
AMOUNT REFERENCE NUMBER
--------------- --------------------
82.08 VISA
---------------
82.08
OWNER ..............
VERONICA LAM
ADDRESS ..........:
19665 MERRITT DR
CITY/STATE/ZIP ...:
CUPERTINO CA, 95014-2437
RECEIVED FROM ....:
CALIFORNIA SKYLIGHT
CONTRACTOR .......:
TERRY KIYAMA LIC # 26844
COMPANY ..........:
CALIFORNIA SKYLIGHTS
ADDRESS ..........:
2250C PARAGON DR
CITY/STATE/ZIP ...:
SAN JOSE, CA 95131
TELEPHONE ........:
(408)866-6759
•
FEE ID
----------
UNIT QUANTITY
------------- ----------
AMOUNT PD -TO -DT THIS
REC
NEW BAL
1BSEISMICR
VALUATION 2,800.00
-------------------- ----------
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
---------- ----------
82.08 0.00
82.08
----------
0.00
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT
0
AMOUNT REFERENCE NUMBER
--------------- --------------------
82.08 VISA
---------------
82.08
RECEIVED BY: PATRICIAG
• TODAY'S DATE: 07/14/08
TIME: 13:18
1
BUSINESS LICENSE TAX
CREDIT CARD
•
•
CITY OF CUPERTINO
RECEIPT NUMBER: BS000005457
PAYOR: CALIFORNIA SKYLIGHT
REGISTER DATE: 07/14/08
CALIFORNIA SKYLIGHTS26844
TOTAL DUE:
$110.00 REF NUM: VISA
TENDERED
$110.00
$110.00
----------------
$110.00
CHANGE
$.00
•
•
•
CITY OF
CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
Ot O7 u I DO
APN # 2
2 / OCA L (i C�
( J
Date:
7� j
/
Building Address:
I 66.5 80�klTi
Mailing Address (if different from building address):
i
Owner's Name:
IJc7e-oro/c6
Phone #:
Contractor:
Phone:8%�9
C14&1Po1 Jeri Ste` L 16i S
Fax:
S
Contractor License
Cupertino Business License #:
Contact: r/
•� � f� � %1-^�1 h1
Phone:
('tfog� iL�d —677
-
Fax:
Residential Commercial ET
Job Description:
jec) > moo P
Building Permit Info:
r
Bldg❑ Elect F Plumb
❑
Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV -HT, V -B
er
n
\`--
Valuation: `
�'az�
Square
Footage:
r
Project Size: Express Standard ❑ 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.builditereen.oru .
Revised r7/
a
CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf
Fee ID
Fee Description
Fee
Permit Type
Group
1GENRES or
1GENCOM
1BBOILERI
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)
1BBOILER2
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
1BBOILER4
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
1 BBOILER5
Installation/relocation of ea boiler or
M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1 BAPPLOTH
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.
1 ELECINSP
Other Electrical Inspections (per hour)
E
1MECHINSP
Other Mechanical Inspections (per
M
hour)
1PLMBINSP
Other Plumbing & Gas Inspections
P
(per hour
1MEETINGIHR
Application Meeting
B
n
•
a 'M
CIN of
• CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IAC.OUSFDW
SFDWL/Duplex New
B
IACOUSRESAD
SFDWL/Duplex-Addition/Alteration
B
1ACOUSCOM
Multi-Family/Commercial
B
CHIMNEY'S
I CHIMNEY
Chimney
B
1 CHIMNEYR
Chimney Repair
B
FENCES
I FENCE>6FT
Non -masonry, over 6 ft in height
B
1FENCEMAS>6
Masonry, over 6 ft in height
B
FIREPLACES
IFIREPLMAS
Fireplace Masonry
B
1FIREPLFAB
Fireplace Pre-Fabricated/Metal
B
IFLAGPOL>20
Flag pole (over 20 ft in height)
B
1MODUSTRU
Modular Structures
B
FOUNDATIONS
I FOUNDREP
Foundation Repair
B
IPILECAST
Pile Foundation Cast in place concrete
B
IPILEDRIV
Pile Foundation Driven (steel, pre-
stressed concrete
B
3 of 5
CITY OF
CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
0
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
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
50')
B
1RETCRB<
Gravity/Crib Wall, 0-10'high (up to
50 ft)
B
1RETCRB>
Gravity/Crib Wall over 10' high (up to
50 ft
B
SHED -(EACH)
Shed Over 120 sq ft
B
SIDING
1 SIDESTBK
Siding, Stone & Brick Veneer
(interior/exterior)
B
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
structural
B
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
st)
B
4of5
n
U
i, , Ss,
C17r OF
• CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
1STUCOAP
Stucco Applications (up to 400 sf)
additional stucco application
B
1 WINREP
Replacement windows/sliding glass
door ea 8 windows
B
1WINMEWSTR
New Window -structural shear
wall/masonry includes plan ck fee
B
/
IEPERMITFEE
Electrical Permit Fee
E
1MPERMITFEE
Mechanical Permit Fee
M
1 PPERMITFEE
Plumbing Permit Fee
P
1 ELCPLNCK
Stand Alone Electric Pln Ck (hourly)
E
IMECPLNCK
Stand Alone Mechanical Pln Ck (hrly)
M
1 PLMBLNCK
Stand Alone Plumbing Pln Ck (hrly)
P
I STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no E/M/P)
hourly -stand alone
B
i
1BSEISMICR
Seismic Residential
B
IBSEISMICO
Seismic Commercial
B
ITRAVDOC
Travel & Documentation
B
IBUSLIC
Business License
B
5of5
•
E
Plan Review Process Work Book Page -12-Revised 3125/08
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
B.
Site
9.
Install H.E. Irrigation, (details/spec)'
L-1
2 points
11.
Permeable Paving, Note
L-1
2 oints
C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
5 points
D.
Structural
3.
Uses Wood kJoist, (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.
Eneigy Star Refrigerator, (Note/Spec.
A-3
1 point
P.
Other
1.
List Green Features on Plans
A-1
1 point
MOMMEAMM
TOTAL POINTS
40 points
•
E
Plan Review Process Work Book Page -12-Revised 3125/08
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
1. Recycle Job Site Construction 8 Demolition Waste
65%=1 point, 75%= 2 points; 80%= 4 points
up to 4 Resource
2. Salvage Reusable Building Materials
4 Resource pts y_
3. Remodel for Mixed Use, Adaptive Reuse, and
•
Historic Preservation
4 Resource pts y_
4. Protect Native Soil
2 Resource pts y--
_5.
5.Minimize Disruption of Existing Plants 6 Trees
1 Resource pt y=
6. Implement Construction Site Stonnwater Practices
2 Resource pts y-
7. Protect Water Quality with Landscape Design
2 Resource pts y--
=8.
8.Design Resource -Efficient Landscapes and Gardens
4 Resource pts y=
9. Reuse MaterialstUse Recycled Content Materials
for Landscape Areas
2 Resource pts y=
10. Install High -Efficiency Irrigation Systems
2 Resource pts y=
11. Provide for On -Site Water Catchment / Retention
2 Resource ots v=
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
C. Structural Frame
1. Substitute Solid Sawn Lumber with Engineered Lumber. 3 Resource pts y --yes
2. Use FSC Certified Wood for framing
(For every 10% of FSC lumber used = 2 points, up to 10) up to 10 Resource pts.
3. Use Wood IJoists for Floors and Ceilings 2 Resource pts y --yes
4. Use Web Floor Trusses 2 Resource pts y --yes
5. Design Energy Heels on Trusses 6' or more 2 Energy pts yryes
6. Use Finger -Jointed Studs for Vertical Applications 2 Resource pts y --yes
7. Use Engineered Studs for Vertical Applications 2 Resource pts y --yes
B. Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y --yes
9. Use Structural Insulated Panels (SIPS)
a. Floors 3 Energy pts Y_—Yes
b. Wall 3 Energy pts y=yes
c. Roof 3 Energy pts y --yes
10. Apply Advanced Framing Techniques 4 Resource pts y=yes
11. Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y --yes
12. Use OSB
a. Subfloors 1 Resource pt y=yes
b. Sheathing 1 Resource pt Y --yes
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
•
1. Install Energy -Efficient Windows
2 Energy pts
• a. Double -Paned
1 Energy pt
b. Low -Emissivity (Low -E) .
2 Energy pts
c. Low. Conductivity Frames
2 Energy pts
2. Install Low Heat Transmission Glazing
1 Enerav of
J. Heating Ventilation and Air Conditioning
1. Use Duct Mastic on All Duct Joints
2 Energy pts
y=yes
2. Install Ductwork within Conditioned Space
3 Energy pts
y=yes
3. Vent Range Hood to the Outside
1 IAQ/Hea@h pt
yeses
4. Clean all Ducts Before Occupancy
2 IAO/Health pts
y=yes
5. Install Solar Attic Fan
2 Energy pts
y=yes
6. Install Attic Ventilation Systems
1 Energy pt
y=ye<
7. Install Whole House Fan
4 Energy pts
y=yes
B. Install Sealed Combustion Units
5 IAO/Health pts
y=yes
a. Furnaces
3 IAQ/Health pts
y=yes
b. Water Heaters
3 IAQ/Health pts
y=yes
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps
3 Energy pts
y=yes
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
y=yes
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
y=yes
12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
y=yes
13. Retmfit Wood Burning Fireplaces
10 Energy pts
y=yes
• a. Install EPA certified wood stoves/inserts
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
4 IAO/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAO/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3 IAQ/Health pts
v=ves
K. Renewable Energy and Roofing
1. Pre -Plumb for Solar Water Heating
4 Energy pts
y=yes
2. Install Solar Water Heating System
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
4 Energy pts
y=yes
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
6. Select Safe and Durable Roofing Materials
1 Resource pt
y=yes
7. Install Radiant Barrier
3 Energy pts
y=yes
L. Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts
3. Plant Deciduous Trees on the West and South Sides 3 Enemv ots
•
it
CITY OF
40:UPEkTINO
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
466-1r
PERMIT #
bk-v % c) 0k
OWNER'S NAME:
PHONE # aP A -
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information -
Oiler/Co actor Signature
2/-
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical?
Ec Q
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
Oiler/Co actor Signature
2/-
to