08060221 (2) -
BUILDINGDIVISION PERMIT
t�+T.�r,• ,ire �+ -.,h ., s"is -.,.•nzsv�..
BUILDING ADDRESS: PERMIT NO.
21100 WHITE FIR CT MAGIC MECHANICAL SERVICE 08060221
OWNER'S NAME: PERMIT ISSUE DATE
HSU WAN—YEN ET AL 1681 MILROY PL 06/25/2008
NE:
SANITARY NO. CONTROL NO.
(408) 978-6181
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
pop LICENSED COMRACTOR'S DECLARATION Job Description
1 handy affirm that 1 m Iieenced under previsions of C'bap cr 9(commencing
_i
with Section 7")of Division 3 offt Bummas ad professional Code.ad my became is HVAC ADD ON A/C ON SAME PMP SEP LINES
< in full forte and Ufxt4,
j�Z License Clan /'' —20 IJc.N 62A32 -
n� Dam l�_e-L�2—GamDECLAKAL0!N/P' g_ '
W �jGs ri AlycxlTEcrs pan"" dtl f .
7 I uMuaand my p��I be mod u public nxoNs
;6u
G
t; Licensed Prefcstlanal
3 OWNER-BUILDER DECLARATION
f 1 bcmby mtrm that I Fort exempt from the Convector's Liccnse Law far the
❑O fallowing wan.(Sedan RD 1.5.Business and Pmftessiom Calc:Any city at county
$f which pupdres s permit re cnmtrtm4 arm,,,Imprew,demolish,nr repot,arty nracturo
_IT prior at l4 issuance.saw requires dm applicant for such permit to file a signed statement
< Na he is licensed pursuant to Ne provisions of the Contracta's License Law(Chapter 9 Sq.Ft.Floor Area1,~ Valuation S (censmemfng with Section]000)of Division 3 of the Basin.and Profess $ions Coda)or 5000
ERR— that he u esempt therefrom and the bus for the alleged eremp ion.Any violation of
section 7031.5 by any applicanl for a permit subjects the applicNt to a Civil penalty of N Number Occupancy Type
net mare than r.handled d.IWa($5001, 35905088 .4H
L u owns of tk prapenty,a my employes vette wags u Jo,v mle eompenaJen,
will do the warp and Nesvtmule is not inuoded mortared forsale(Sec.]OM,BUJMv.
aM Profes ion l Cade:The Cameron's L..Law does at apply,.an awns of Required Inspections
property who buildsorimprower Jo,reon,and whodoessuch workhimselfmthreugh his
awn employees.provided Jw such impreemenu arenot I.,, moReled fosude.V•
however,Ne building or improvement is sold within ane year of completion,to owner.
buildec will baw do,burden of proving Jut Im did not Wild or improve for puryo¢or
ue.).
1]1,u awmr of use property...uelusiwll,comate.,with Hemmed canuactor to
construct the propel(Sec.709d,Business and Profusions Cade:)The Cmmemrs U.
came Law docs not apply u in owner of pmpwy who Wit"or improv$$Nerean.ad.
wino contracts for such pmjccs with a conaxtor(s)licensed pursuant to the Contractor's
License Law.
I a r,ammpt under See .B A PC for Nu won
Owren Das
WORKER'S COMPENSATION DECLARATION
1 hereby afro under penalty of perjury One of the fallawing decla mmol:
I have arW will maintain atCertiftate of Co..,in self-iwtre for Wafer's Ccmpcn-
cation•u provided far by Section 3700 of do,labor Code.for in.performance of the
work for which Nis permit is issued.
❑1 haw and will maintain Worker's Compensation lam-mco,as required by Section
3]W of Jo,Labor Cade.far the performance of the work for which uses remit is issued. -
My Walker Compensation Instance Cartier and Policy number
Carrier. +CiC/ERvufIFl/ numberare,
OPolcyNo.:
'q 'OZ'
0 TION
FROM WORKERS'
COMPENSATION INSURANCE
mticsccum need not be dropmed if the Permit is format hundred dollar($109)
or kss)
I certify that in the performamc of the work fa which this permit u caused.I"I not
.mploy arty person in any matter se as to become subject,.the Wartrn'Compematim
Laws of Califamia.Date
Appliom
NOTICE TO APPLICANT:11•after making this Cenircale of Esemption,you should
,ecome subject to the Wmteei Compenuum provisions of Ju labor Com,yes,am
,Z foMwith comply wit such provisions;or this permit shall be deemed revoked.
'Z O CONSTRUCTION LENDING AGENCY
[--m 4 I hereby alrm that Nem is a comaucabn ending agency for the performance of
a> the work fm whim this permit is named(see.309],Civ.Cl
G Landers Nark
7 z Lender's Adw
d
U O 1 testify Nat I have read this application W sum that the&bow information u
IL.H roma I agree Or comply with all city and county addressees and sum laws mlaung m
0 U Wilding construction,and hereby auNadm reprosent iws of Nu city m sur upon du
W abave.menudgm property forinspectionpurpaxs
(WO)agree m sew•indemnify and keep hamea the City of Cupertino against
Z toO.itim,Judgme thocrosand mpcmm whichmay in anYwyamte agaim4u0 Cit
U,'� A APPLICANT
of NegrantingofNis t.
APPLICANT UNDERSTANDS A ILL COMPLY WITH AL ON-P Issued by:9 Dat
SOURCE REGULATIONS. �
siginarear P Co ler Dau Re-roofs .�-'
/7
x DOUS MATERIALS DIS RE Type of Roof
Will tha.ppl' tar rut=building occupantsmm orband ore maurial
as defiled by Use Cupertino Municipal Cade,Chapter 9.12.and HcaIN and Safety
Code,Section.255324)? All roofs shall be inspected prior to any roofing material being installed.
Yu
Will thc applicant ar mule building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it h.vamnm air canuminants as defiled by the Bay Area Air Quality Management all new materials for inspection.
D strict?
❑Yes o
I haw mad the ha material.lequiremenuunder Chapu6.95aftheCalfm-
ni.k%fthhSafctyCodoSeu b505.25533md]5M 1underndrhatifJu �ud
lba�ii
ebcllirymmdfyJu tiU'am,Jam ret umndy h.w a
requimmnt,whichm ans state 0 GO plawy.
Signature of Applicant Date
6 �C4 0
own m, cd,g nt Dote All roof coverings to be Class'As'or better
CITY OF CUPERTINO
• 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . 1 : 35905088 . 00
DATE ISSUED. . . . . . . : 06/25/2008
RECEIPT # . . . . . . . . . : BS000005221
REFERENCE ID # . . . : 08060221
SITE ADDRESS . . . . . : 21100 WHITE FIR CT
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER HSU WAN-YEN ET AL
ADDRESS 21100 WHITE FIR CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4037
RECEIVED FROM . . . . : BORIS SHEDRIN
CONTRACTOR . . . . . . . : SHEDRIN, BORIS LIC # 21762
COMPANY . . . . . . . . . . : MAGIC MECHANICAL SERVICE
ADDRESS . . . . . . . . . . : 1681 MILROY PL
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE (408) 978-6181
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 5 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MRRAA I UNITS 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
1PPERMITFE 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 396 . 04 0. 00 396 . 04 0 . 00
METHOD OF PAYMENT AMOUNT .!' REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 396. 04 VISA
---------------
TOTAL RECEIPT 396. 04
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
CITY OF CUPERTINO
r--g FURNACE/AC
OF
•CUPEkTINO PERMIT APPLICATION FORM
APN # 3t, 90 O G U C) Date:
Building Address:
// O
Owner's Name: Phone#: .2 'g--7 — 3
Q.k rs�
Contractor: // Phone#- .- -
!Pe Le /2-/P amt - Fax #:
Contrac r License #: Cupertino Business License#:
823 Z.
Contact: / p Phone #:
/ Ar Fax #:
Building Permit Info:
Elect Plumb Mech ❑�
Residential Commercial ❑
Aak
Job Description:
�p Q
er R V u ` -0^
For Residential Installations:
Attic ❑ I't floor 2nd floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
- S--/L , 1�- -3
Strapped On Platform ❑ Bonded New Location Replacement
Project Size: Express L�- Standard ❑ Lar e ❑ Major ❑
Valuation:
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.
Revised 6/16/08
CITY OF CUPERTINO
FURNACE/AC
CITCUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code. '
1 MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code. •
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed¬ incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or •
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/ or M
replacement of ea appliance vent
install & not incl in an annI nemlt.
CITY OF CUPERTINO
L� FURNACE/AC
CITY OF
•CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
IMFR=<100 Furnace Syst <=100k BTU install or M
relocate ea forced-air/gravity type
furnace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
IEPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
CITY OF CUPERTINO
FURNACE/AC
CUPEI,TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= l0k CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREMAIRHAN Residential A/C units <= 10k CFM B
1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B •
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRAVD0C Travel Documentation B
1BUSLIC Business License B
•
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
q.
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. A4 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 oint
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 RDSDurces Energy IAO/Health
A.Site
1.Recycle Job Site Construction&Demolition Waste'
65%=1 point;75 = 2 points;80%=4 points up to 4 Resource pts D
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 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 MateraIWUse 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
NOW
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 I
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 1 D) up to 10 Resource pts. 0
3.Use Wood Woists 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=yas 0
12,Use OSB
a.Subfloors 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0 •
1 1
INPUT Resources Energyl IAO/Health
I.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 Dud Mastic on All Duct Joints 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts Y--yes 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 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
S.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 31A0/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 0
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 stovesfinserts 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/Health 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 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
(12 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 16 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yesp
N I
I 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 p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1 1
•
Community Development
i s 10300 Torre Avenue
}� Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPEkTINO
Building Department
JOB ADDRESS: PERMIT #
,-214100 Cd K<' �� C, r �� D�d�d Z 2
OWNER'S NAME: GI/a o, PHONE #
GENERAL CONTRACTOR:Ilk C- FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the followin information:
EF-SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
. Linoleum/ Wood
Glass / Glazing
Heating /(lQ Q, tea- 6 2 2 3 Z
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date