08070202 (2) CITY OF CUPERTINO 'a
BUILDING DIVISION PERNIIT CONTkkOTORINFORMATIO Mw
BUILDING ADDRESS: PERMIT NO.
1.04'1.1. S'T'OKES AVE CALIFORNIA BATHROOM & 08070202
OWNER'S NAME: PERMrT ISSUE DATE
CROSBY 1261 LINCOLN AVE STE 204 07/28/2008
NE: SANITARY NO. CONTROL NO.
(408) 360-9700
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
-BLDG ELECT PLUMB MECH
0 0 0 0
3oa
LICENSED CONTRACTO SDE LAILATIDN itEJob Description
1 bmeby afftam But 1 am Ranged under Provisions of Chsp err 9(commencing
z1NhhSadOn70(Kr).fDtvisn3ofuceusinewendProfessiouCedeandmylre"', RPLC BTHRB&SIIWR VALV SM LOCTN RE—TILE TO CEILNG;
ren forte andertea �. G CLS 8-717
,LIZ Lnu ls.0ncow. NO ELCTRCL&NO LITNG
DECL
g' Da1C Can
7
ARCHITECTS ECLA A O
Ss i u I undersund my plans shall M used a a
public m nds
y�(n Licensed Professional
5 OWNER-BUILDER DECLARATION
3 r E 1 hcmby affirm am exempt I aexempt from de Contractor's Lieenu Law for Iho
00 following mason.(Salon 7031.5.Business and Professional Corm:MY city a,county
S$ which«quhm a perm,to construct,slur.improve.demolish,or spoor any swclum
_Z< prior to its issuance,ala requires the applicant forsuch permit m file a signed statement
ss Sq.Ft. Floor Area Valuation
NathulicenedPalmertothopravismasoffsConosm'sLdanelaw(ChapuT9
YF$ (commeneing with Sagan 7000)of Division S of the Businegand Professions Code)or $7900
CRE that he is attempt therefrom and the basis for du alleged manmpthon.Any violation of
Sagan 7031.5 by any applicant for a Permit subjects the applicam as a civil Penalty errNumber Occu ane T e
rot mart Wan five mention!dollars ISM 32647028 . p y YP
❑I,uowmr orlhC pmpmry.mmY emPloyw wilt ngduNeh ale compenada,
and
Professional
and Ne he Coo ISats Live or Law
du
a at apply
in an Bualnea
and property,
whom Cade:The camramme.Liar law dao or apply lf rt awes err _ Required Inspections
Own em whobuildaed that menen improvements
andaltodoesouchwork himself err through his
awnemployees,provided pr impmwmwt art not intendedar Acores.for a eon,
whew,.the Abdng or improvement u sold within arc year of i m rove,r ,the owmr-
age). NB hate fe bmdra of poring mar K did rot MgW a impale!a purple of ,
. ❑I.as owls of the Muttony.w exclumm"andraning with licensed conoalms m
answer the project(Bee.7014.Buims and Pmfessiou Cade:)The Coou.cur's Lt,
crew Law does not Stogy to an owner of psopeny who build or improves th arem.and
who cmuacu Car such potgas with a canlacma(s)Ikcned puauanl as the Contractor's
Lienee Law.
O lameempunda Sea .B&PCfmdusreasan
Owner Date
WORKER'S COMPENSATION DECLARATION
1 bemby&Mres under penalty of perjury oro of fe folWwing derLrW
Ihawandwillmalnuin acro riicauofconsentmelf-alumrmwo SCompel
ration..,provided ror by sauan 3700 of the labor cad.rex fa pearmm.na of the
)TI
for which this Permit u WOOL.
Cl 1 have and will mainom Warlues Compenadon luurut¢,as restated by Sagan .
3700 of due Labor Cade,fm the peRermanre of the,wort fmwhlch this permit u Issued.
My Workz Com nada buunna arriv"Pull numb..:
/N,,. T �r/ 3O ..
Cartier. Y EXE Polity FROM
CERTIFICATE OF SAIIO INS RAN WORKERS'
COMPENSATION INSURANCE
(Thu Salm reed notbecompleud if Lk Permit is foram handled dollen(SIN)
Or los)
I cugfv that in the performance of the wark for which this permit Is issued,l shall not
employ mypason in any m m urm as m become subjecl to the WorkersCorav nsadon
Laws of California Dau
Applicant
NOTICE TO APPUCANI'.If.alar making this Cedficaw of Exemption,you should
become subject m the Worker's Competition provisions of Nc labor Cada you most
.J O forthwith comPIY with such povlgom err Nu permit shall be named ewkcd.
E 7 CONSTRUCTION LENDING AGENCY
[-+.N. 1 lemhy dr..that fel I..construction mni ing.gasy m,the preforms«of
C >
the were for which dd pmrlt a meed(ser.30m,civ.C.)
A Lender's Name
,Z Lender's Address
U O 1 ardly,that I hate and this application and sum Nu the Show IMmmatiun is
Lt.C);^ carsm I agnea ac comply with all ai and county magiveeea and sou Ian relating te
D SV' building cukased on,and knotty auNon Professes.rtwan of Nu cityuenterupn Lha O�
shove-lemoned property for"Forme whichm (/`^!/KJA/
F y (we)agree m saw.indemnify and kap hatless the City of Cupertino against
f/j inconsequeceofthe swung of this
may in any nyaame agalulsaid City
U Z APPLI ANT of UNDERSTANDS
of AND mit
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
�/1-f —1-1 7 AS Re-roofs
Sigma ue,of AppllnandComocror I Due—
HAZARDOUS MATMUA1S DISCLOSURE Type of Roof
Will ft wpit.,or rumor wilding oaepar nam or Studio haatdoes mumu
as defined by Ne Cupdnino Municipal Code.Chapter 9.13,mrd me RUIN and Safely
Code.OYu den 25532(.)7 kfM All roofs shall be inspected prior to any roofing material being installed.
will Ne applicant or future Wilding occupant tea equipment or devioss which If a roof is installed without first obtaining an inspection,I agree to remove
1 ha umd-us it arualmens as defined by Ne Bay Arta Air Quality Management all new materials for inspection.
W
Dict7 p
❑Ya ,@Nu
w
I have read the magal a'materials murstannagoader Chaser6.95 of Ne Calirm- /7
nice HulN&SdctyCod0.Savm OM3.25533ub25534.1untixsuM irNc hwlding
does ml arrandy haw•terns that h 4 my mapamibility u rsafy tw aaupat of the
equimmcn mustWmet Pour eiauamcof.CabiiueofOlccw"1r 19ignatureofApplicant Date
Owner wauNorirzd agent Dau
All roof coverings to be Class" cog assor better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 32647028 . 00
DATE ISSUED. . . . . . . : 07/28/2008
RECEIPT # . . . . . . . . . : BS000005612
REFERENCE ID # . . . : 08070202
SITE ADDRESS . . . . . : 10471 STOKES AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CROSBY
ADDRESS . . . . . . . . . . : 10471 STOKES AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : ALLYN JOHNSON
CONTRACTOR . . . . . . . : JOHNSON, ALLYN K LIC # 21160
COMPANY . . . . . . . . . . : CALIFORNIA BATHROOM & KITCHEN
ADDRESS . . . . . . . . . . : 1261 LINCOLN AVE STE 204
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 360-9700
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
I.BSEISMICR VALUATION 7, 900 . 00 0 . 80 0 . 00 0 . 80 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
ISUPINSFEE HOURS 0 . 50 61 . 00 0 . 00 61 . 00 0 . 00
1TRAVDOC FLAT RATE - 1 . 00 40 . 79 0 .00 40 . 79 0 . 00
---------- ---------- ---------- ----------
`1.'OTAL PERMIT 143 . 38 0 . 00 143 . 38 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 143 . 38 MC
---------------
TOTAL RECEIPT 143 . 38
•
OS 07 -o
" MDF. CITY OF CUPERTIN
CIN OF O
CUCPEIZTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # .�P q 7 _717- V/v b'
Building Address:
O Y ] 1. STO K-Ti,) AVL .
Mailing Address (if different from building address):
Owner's Name: CR-OS
(ZO S R y Phone#:q•7 3 — , y L y
Contractor: V / Phone:
CAL/ For-All A bh-r 14ao-n A-K,rrCHS/ V
dL�M � Drz��uls ;T,-C. Fax: 7 91
Contractor License#: 6 cl 8 7(&
Cupertino Business License#:
Contact: Phone: I/v,r_ Ll y i? - b70
AL,t,Y.✓ TD
• Fax:
Residential Commercial
Job Description:
ViL?i,A-Cly 6AT-147VOd' 54oWPh- VALVPE &-AAl1 (_Z (ATT/ON
�R-T(Lri TO CIE /L/ NG• //,o -6/U =C7-1k- kCl�L _ A.---> J_(
Building Permit Info:
Bldg U,-' Elect ❑ Plumb 03/ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
I-A, I-B ❑. IUIII/V-A ❑ IUIII B, IV-HT, V-B �3
Valuation:f Square ootage:
Project Size: Express S--�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.buildit reen.or
Revised 7 /$
'- CITY OF CUPERTINO
CUPEI,TINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
I BBOILERI 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)
IBBOILER2 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
I BBOILER4 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
1BBOILER5 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)
IPLMBINSP Other Plumbing& Gas Inspections P
(per hour) •
IMEETINGIHR Application Meeting B
CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL,/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
(CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1 FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry. B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
I FLAGPOL>20 Flag pole (over 20 ft in height) B
IMODUSTRU Modular Structures B
FOUNDATIONS
IFOUNDREP Foundation Repair B
1 PILECAST Pile Foundation Cast in place concrete B
1 PILEDRIV Pile Foundation Driven(steel, pre- B
stressed concrete
3 of 5
M CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONR
1RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-1Q' high (up to 50 `) B
1RETSP10 Special Design, over 10' high(up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high(up to B
50 R
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1 SIDEST/BK Siding, Stone& Brick Veneer B
interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1SKYL>lOSF Skylight greater than 10 sf or B
structural
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 B
st .
4of5
'G�- CITY OF CUPERTINO
a
CITY OF GENERAL BUILDING APPLICATION
• CUPEkTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
IGENCOM
1STUCOAP Stucco Applications (up to 400 sf B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows
1 WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
/ 1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
/ ITRAVDOC Travel & Documentation B
1BUSLIC Business License B
sorfs— ✓ ¢�- d ,a .
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 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 oints
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. Ener 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.
INPUT Resources Energy IAG/Health
A.Srte
1.Recycle Job Site Construction 8 Demo Ifficin Waste '
65%=1 point;750h= 2 points;60%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials. 4 Resource pts y yes D
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 Stornwater Practices 2 Resource pts y--yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y--yes 0
B.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% •
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--yes 0
1 I 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered L`umber 3 Resource pts yryes 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 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 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
6.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 A011-lealth
Windows
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 0
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 yeses 0
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 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 0
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 y7yes 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 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 p
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/Heaith pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes p
1 1 1
K.Renewable Energy and Roofing
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,3.5 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 1
3 Energy pts y=yes 0
1 1
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
3,Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
• 1 1 1
■■■
■■■07
From Planning H Design to Detailed&Quality Craftsmanship
BAH R(0DM ■■■ License No.698718
KITCHEN name 1261 Lincoln Ave. #204 • San lose, CA 95125
■■■■
408-360-9700 • Fax: 408360-9797
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.� Community Development
10300 Torre Avenue
1' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OCUPERTINO
Building Department
JOB ADDRESS: PERMIT #
OY -7 ( S7 K-ej ia-ve. 0 0-7DaD�
OWNER'S NAME: C 20 5 G y PHONE #
GENERAL CONTRACTOR: AL r r-o 2 r rr (SykG tea/ r AX #
I am not using any subcontractors: 4� //Z — 712-X c�
Signature Da e
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/Contractor Signature Date