08080065 (2) CITY OF CUPERTINOxs
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BUILDING DIIY �av OSION PERMIT VT� QLVs' 0� .
BUILDING ADDRESS: PERMIT NO.
/80 SQUIREHILL CT TBD — TO BE DETERMINED 08080065
OWNER'S NAME: PERMIT ISSUE DATE
IJ I.,Y YEY 08/08/2008
NE SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
RE—PIPE WATER MAIN FROM CITY BLDG ELECT PLUMB MECH
e 7_1
0 0 0
300 LICENSEDCONTRd underSDECons aroONTe Job Description
(uj eherebyaffirmaha1me 3limedunderprovisionsofuCedi 9mylumncing --------- —••^ "- - - p .
WIN Stone..d.f of Divitlon J alta Butlness and Profe.tlons Code,arW my Ikense 4
^ , in full Imre and eGecL
Lt....Class —3aLle.0
Dam Contractor
ARCHITIEC711DECLkRATION
I understand my plans shall W used As public soma
a tad Licensed Professiontl
5 tat I Am BUMPER m CIa0.AlacN
9 I,hereby. sRm e. 1 em excmp from the Contractors License Law far to
0 0 following mama.(Behan ToL.3,Busl W. and ne.dcom"Cents:,oAnti city err many
as�i which requima a Permit wr.h.thnoncontract,alto,,W pm In de Permit
ri mp.ir anti structureanet
iy tambiLLcensedx,almoq,the do apions ofant for Conmemitm Bless Lw(Cha"cot
�g (commc liavdpurmmlmNcpmviiomofoMC°nummr'Wu°mlaw(CNPm 9 Sq.Ft. Floor Area Valuation
$ mal he 4 emgwlth Section1000)andtfDivision nw the
N Alleged eaceptne.s and Any
Code)or
— dal k b campy,Any Indo and the bub it do objects
to esemant in Any vio malty of
out Wo a to w amt applies"Ito s permit mbjem time applicant to a civil penalty m APN Number Occupancy e
not mom Nm Ow hundred dolLLn($SOOh p y Typ
0 1,An wwvr of the property.or my employ"wit wag"a dkir mk compnnsadon,
will do the we&and to a°actm:b not intended reoffered for Asia(sec.7000.Buumss
Add Professions cod. a
T.Conumes Limn "to
Law dot apply to an Amar of Required Inspections
propertywho builds m improws thence,and whoduesauch ,it himsellar through his
Me nmplayen,provided that Inch Improwments am nay mu mded moRnned fmsak.if.
Imam.to Wilding or Improwmcnt is old W Nin one y Wr of completion,the owner.
build".01 Arm the burden of moving that Its did not Wild as impose fer purpose of
sate.).
0 1.As a .of du property am exclusively contracting with licenced comranan to
covuum do pmIm(Sec.RHO.Be,!..and Profestlm s Code:)Ian Comtraetof.U.
comn law does not apply to an owner of property who Wilda or improwa theme,sed.
who conamLLfor such pmjecu wit a comnctor(s)licensed prow,to use Consumes
License Law.
[Ilan"enptundm Sec. ,Bd PClmtiswmmw
Owes, Dam
WORKER'S COMPENSATION DECLARATION
1 y alarm under penally o(pejury men of les following declarelav:
aw and will mainWn aCeniB"�af Covent m sell-loom Ito Wohers Campo- "'
andon,As provided fer by Section 37M of do lobar Code,fm the performance of do
were for which min Permit is issued.
0 1 haw and will maintain Worker.Compensation Insurance,u required by Solan
370D of the Lab"Code,fm the Performmed of do Anal,for which tis pnmii is issued '
My Workers Compensation Insuran¢artier and Polley number K:
Carver: Polly No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
flMsmmlon need not he completed If tk permitb f°rone hundred dollars($ImB
or leas.)
1 coolly that in to Performance of to work for which this pcmR b issued,I dull not -
employ guy person inAny b' tite wRtl¢ra'Compevadan
Chun m rte m
Law.of California.D
Applicent
NOTICE To APPLICANT.If,after making this Comfiest° nnpuon,you should
hundred objet to the Worker.Compeaadon Provisions of the labor Cade,you muss
D O forthwith comply wit such provisions or tis permit shall k doomed mmked.
,Z.,r CONsrEucnON LENDING AGENCY
[-+� Ihembi,affirm that Nem u a covtmetion lending agency for do performmnc of
C4the work for which Ws permit Is issued(Sec 7197,Civ.C.)
SQ Lender.Nano
0 z Lemice.Address
U OL 1 wrdfY that 1 haw read this applieNon and smto to to abuw Information is
LL corm"I agmen to Comply wit LI city and county mdinmm,and sok hews muting to
V
Q building cmatrAnd d hereby authorise mpnesucc iws orthb city to now upon the
CA aWw-moudgm Popery for ins PcAm Purposes
0. (We)agree to awn indemnify and keep humanists,the City of Cupertino against
n..,IA incoiammeraeoffteruueng en theses which mryin any nysemnagalvtaid City
U�,• in coreequcrus a(the grsnun{of this pcmik
^ APPLICANr UbPERSTANDS AND WILL COMPLY W�TH ALL NON-POINT Issued by: Date Jowl,
SOURCE R ATIONS.
O Re-roofs
sallifinum fApplicenuComm�or De
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will decappllcmy m future building nceupnlame m handle hammons material "
As defined by the Cupertino Murddpl ,Chapter 9.12 and to H"It and Safety
code.."len 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑m o
coin the.applicant or fu um Wilding tutu nth use equipment If a roof is installed without first obtainingan inspection,I agree to remove
PP S p q pnrmt or devise which P g
sthnavamans air conuminsnu u definsd ay Aura Air Quality Management all new materials for inspection.
0 Y"
I haw mad the havrd°ua materials mqukmmu under Chapter 695 of the Califon.
nbHcolthhS.fctyCock SccdMZ5505.25533md25534.1undeoandthulfdn Wilding
Janes tot,meemi hew a tenant that is b ort respomiblluY to noufy Nc aceupant of the
roq°Item°nu hours Wmet piarto fore" S ignature of Applicant Date
mer err utamtd agony k All roof coverings to be Class'jg"or better
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36223024 . 00
DATE ISSUED. . . . . . . : 08/08/2008
RECEIPT # . . . . . . . . . : BS000005730
REFERENCE ID # . . . : 08080065
SITE ADDRESS . . . . . : 7780 SQUIREHILL CT
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER LILY YEY
ADDRESS 7780 SQUIREHILL CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5017
RECEIVED FROM . . . . : ANANTA SMITH
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ----------- ---------- ---------- ----------
1BPWATER UNIT 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1BPWSVCS WATER SERVICE 1 . 00 20 . 40 0 . 00 20 . 40 0 . 00
1.13SEISMICR VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
7.TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 143 .47 0 . 00 143 . 47 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------- --------- -----------------
CHECK 143 .47 149
TOTAL RECEIPT
143 . 47
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
1.06 SEWER & WATER 301 ROUGH PLUMBING
507 FINAL PLUMBING
CITY OF CUPERTINO
�t q1
REPIPE/SEWER/MAIN SERVICE
CUPERTINO PERMIT APPLICATION FORM
APN# D f) 0
^� Z� Date: p
lL O
Building Address:
Owner's Name: / r/ V Phone#: !7p k
Contractor: Phone
Uq Le W5 /U✓s'l�/I Fax #: T/ Z ,Z-
Contact: Phone #• - L39
/Y/// `/ Fax #: /� 2.� ./3Q
Contractor License
Cupertino Business License#: Q
Job Description:
GtJLia/�— �o v� ��.
Residential Commercial ❑
Valuation:
U �p
Project Si e: Express LJ 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 ICPSS
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial p
/ 1BSEISMICR Seismic Residential P
IPRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPERTiNO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P I RPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
/ 1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
IPGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
1PPERMITFEE Plumbing Permit Fee Issuance P
IPLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
ITRAVDOC Travel &Documentation Fee B
J 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 ROME= ill 11 1 MORE
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
•
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.
. rte
1.Recycle Job Site Construction&Demolition Waste V)
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts D
12.Salvage Reusable Buil ___ — _- — P 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 D
7.Protect Water Quality with Landscape Design _ 2 Resource pts y=yes 0
[B:pesign Resource-Efficient Landscapes and Gardens 4 Resource pts y--yes D
9.Reuse Material"-e 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 D
1 f I
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 D
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes p
1 1 !
C.Structural Frame
rf Substitute Solid Sawn Lumber Wwith Engineered Lumber_ 3 Resource pts y--yes p
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 1 D) up to 10 Resource pts. 0
3.Use Wood IJoists 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 D
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
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 Ener is
9Y P 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 D
`12.Use 0S8 -- --__ -
a:Subfloors 1 Resource pt y=yes 0
• b.Sheathing 1 Resource pt y=yes p
1 ! 1
xter or ms
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y--yes 0 i
b.FSC Certified Wood 3 Resource pts y--yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health pt y--yes 0
3.Install House Wrap under Siding 1 IAQ/Health pt y"—Yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt Y_—Yes 0
{ { 1
E.Plumbing
1.Install Water Heater Jacket 1 Energy pt y=yes D
2.Insulate Hot and Cold Water Pipes 2 Energy pts Y_—Yes 0
3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b,Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
,4.Replace Toliest with Ultra-Low Flush Toiiets
(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y--yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts Y_—Yes 0
7,Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0
6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 i
v.trecuncai '
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. 0 .
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
{ 1 1
G.Appliances
1.install Energy Star Dishwasher 1 Energy pt Y--yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
'3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y--yes D
CMM
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pis Y_—Yes 0
b.Ceilings 2 Energy pis y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 3 IAQ/Health pis y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes 0
b.Ceilings 4 Resource pis y=yes 0 .
S.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes D
c.uewngs 4 Resource pts y=yes 0
1 1
_11111711W.ows INPUT Energy IAWrienith
1.Install Energy-Ef icienl Vdindows
a.'Double-Paned
1 Energy pt y_yles D
L b.Low-Emissivity(Low-E)' 2 Energy pts y=yes D
. c.'Low.Conductivity Frames 2 Energy pts y=yes 0
2.InstallLow Heat Transmission Glaiing 1 Energy pt y=yes p
1 1 1
J.Heating Ventilation and Air Conditioning
r1.Use butt Mastic on All Duct Joints . - 2 Ener is
_ 9y P Y=Yes 0
2.Install Ductwork within Conditioned Space _ 3 Energy pts y=yes p
3.Vent Range Hood to the Outside 1.IAQ/Health pt y=yes p
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts yryes 7
p
5.Install Solar Attic Fan 2 Energy pts Y--yes 0
6. Install Attic Ventilation Systems 1 Energy of y=yes p
7.Install Whole House Fan 4 Energy pts y--yes C
B.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes C
b.Water Heaters 3 IAO/Health pts y=yes p
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts yryes 0
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 D
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 stoves/inserts 1 IAQ/Health pt y=yes C
b. Install/Replace Dampers 1 Energy pt yryes 0
c. Install Airtight Doors 1 Energy pt y=yes C
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 4 IAQ/Health pts y=yes C
16,Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAWealth pts y=yes C
1
K.Renewable Energy and Roofing 1 1
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,2A kw=12 points,3.6 kw=1 B points) Up to 1 B Energy pts p
6.-Select Safe and burable Roofing Materials _ 1 Resource pt y=yes 0 -
7. Install Radiant Barrier - 3 Energy pts y=yes p
1 1
L.Natural Heating and Cooling 1
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 p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1 1
•
Indoor Air Quality and Finishes
1.Use LowMo-VOC Paint 1 IAQ/Health pis y--yes 0
2.Use Low VOC.Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3,Use Low/No VOC Adhesives 3 IAO/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61A0/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAO/Health pts y--yes 0
S.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D
9.Use Finger-Jointed or Recycied-Content Trim 1 Resource pis y--yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
! 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 Resource pts y=yes 0
12.Use Rapidly Renewable Flooring Materials 4 Resource pts Y--yes 0
3,Use Recycled Content Ceramic Tiles 4 Resource pts Y--yes D
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts yryes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pis Y--Yes 0
6.Install Recycled Content Carpel with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total olntsval a e: 1401 1301 57
Total Points Project Received: 0 0 0
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•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
g UMkTINO
Building Department
JOB ADDRESS: //� PERMIT
OS Uii� O d 0
OWNER'S NAME: G/� PHONE # �p
GENERAL CONTRACTOR:
o.� SH-r•i`�i
I am not using any subcon actors: 8 ��
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
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
� cr 4-,
Owner/Contractor Signature D to