09040040 CITY OF CUPERTINO
BUILDING DIVISION PERMIT � AT � � ` � '
BUILDING ADDRESS: PERMIT NO.
7731 SEEBER CT VALLEY HEATIjjG_L_QQQL2N_G__ 09040040
PERMIT ISSUE DATE
OWNER'S NAME:
TATT`T_T_PR ()WF.N T ANDT14F6RF6SA n
S A CONTROL NO.
INfiF:
(408) 254-6290
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDG ELECT PLUMB MECH
0 0
v p C LICENSED CONTRACTOR'S DECLARATION Job Description
V I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 70(X0)of Division 3 of the Business and Professions Code,and my license is
y in full force
andeff% /) RPLC FL RNC& ADD A/C
z License Class L`� Lam-K
n y Date Comractor
ul ARCHrrEF S DECLAR ION
a` l u in p s all pu • c ds
�yU
L y License
n y; O NER-BUILDER DECLARATION
crcby affirm that 1 am exempt from the Contractor's License Law for the
p O following mason.(Section 7031.5,Business and Professions Code:Any city or county
K m 8! which requires a permit to construct.alter,improve,demolish,or repair any structure
a Z y prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation
F_G that he is licensed pursuant to the provisions of the Contractor's Li��ense Law(Chapter 9 Sq.Ft.Floor Area
X
t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $6300
y that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(5500). 366260-': 4 . 00
I,as owner of the property,or my employees with wages as their sole compensation,
willdothework.andthestructureisnotintendedorofferedforsale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License law does not apply to an owner of
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If.
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑I,as owner of the property.am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li-
cense law does not apply to an owner of property who builds or improves thereon,and.
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License law.
I am exempt under Sec. B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a Certificate of Consent to self-insure for Workers Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
Qjjhavc and will maintain Worker's Compensation Insurance,as required by Section
3700 o the Labor Code,for the performance of the work for which this permit is issued.
My Wor mpensation asurance carrier and Policy ram
�er Policy No.:
—CERTIFICATE OF EXEMPTION FRO W KERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or less)
I certify that in the performance of the work for which this permit is issued,I shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the tabor Code,you must
Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z OCONSTRUCTION LENDING AGENCY
[~—m rA I hereby affirm that there is a construction lending agency for the performance of
(�^✓ the work for which this permit is issued(See.3097,Civ.C.)
WW A Lenders Name
Lender's Address
U C) I certify that I have read this application and state that the above information is
LL" correct.1 agree to comply with all city and county ordinances and state laws relating to
0 V building construction,and hereby authorize representatives of this city to enter upon the
a above-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilities,judgments,costs and expenses which may in any way accrue against said City �r-i ,�
(�Z in consequence o'U�IhIS DateAPPLICANT UNDPLY WITH ALL NON-POINT Issued b.✓:
SOURCE REGULA
Re-roof: -
Signature of7Antruto Date
RD ATF-RIALS DISCLOSURE Type of Roof
Wilrfuture building occupant store or handle hazardous material
u define o Munic' al Codc.Chapter 9.12,and the Health and Safety
Code, tioAll roof:;shall be inspected prior to any roofing material being installed.
❑Yes No
Will the applican r future 'ding occupant use equipment or devices which
If a roof is installed without first obtaining an inspection,I agree to remove
lit hazardous air con minants as med by the Bay Arca Air Quality Management all new 1 naterials for inspection.
.istrict?
❑Yes o
I have mad the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safcty Codc,Sccti "05,25533 and 25534.1 understand that if the building
does not currently have a ten a ' responsibility to notify the occupant of the
requirements which must r uanco of a ecru tcate of Oc Signatur-.r of Applicant Date
All roof coverings to be Class'R:i'or better
Owner or au o'. are
09oyOD o
CITY OF CUPERTINO
CI �J FURlvACE/AC
CUPEkTiNO PERMIT APPLICATION FORM
APN# 5G D 3 Lf -
� Date:
Building Address:
r7 r7 2 1
Owner's Name: Phone#: LIC8 66,5---
OLADP,n . !5r7 '7?'
Contractor: Phone#: q68 _ -r'yG-bad
6 Fax #: '4L8 —a954-629- 47
Contractor Licen e#: Cupertino Business License#:
,25--'F5cl(D A//
Contact: Phone#: 465 _a.47eyr- —&P-9-n
f-% c-- ::::�o f\e� Fax#: X-2-#
Building Permit Info:
Elect B?//
Plumb ❑ Mech
Residential Commercial ❑.
Job Description: rep s �� :��--e- ! �"r!' J J
For Residential Installations:
Attic El 1St floor [ 2"d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installativa ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction(Usage Class):
(v , 30-t>
Strapped ❑ On Platform ❑ Bonded ❑ New Location ❑ Replacemen
Val ation:
Green Building: Must attach Green Building Check list to this application
CITY OF CUPERTINO
FURl1TACE/AC
- CITYof-_
CUPERINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE - - FURMAC
1MCRAA Commercial-I:epair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,a:)sorption unit,or ea
heating,coolir-g,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
IMCREPALT 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.
IMCSUSHTR Commercial Install/Relocate ea M
suspended he iter,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical f or ea gas piping System P
1-4 outlets
1BPGAS For each gas-)iping system of 5 or P
more per outlet.
1MCAPPVNT Commercial -..-or the install/relocate/ or M
replacement of ea appliance vent
installed &riot incl in an appliance
permit.
1BSEISMiCO Commercial3eismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,,Lbsorption unit,or ea
heating,cooli ag,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential vistall/Relocate ea M
suspended he ater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential f)r the install/relocate/or M
replacement :)f ea appliance vent
install ¬ incl in an a pl permit.
j,
CITY OF' CUPERTINO
FURNACE/AC
-CITY OF - - - - -
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
—IPGA-SRES -Residential ft,r ea gas piping system of P —
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per out]et.
1BSEISMICR Residential S--ismic B
1MECPLNCK Mechanical I Ian Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea fcrced-air/gravity type
fumace/bum(.r, 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 fcrced-air/gravity type
fumace/burn,,-r, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1EPERMITFEE Electric Pernut Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Pe-mit P
1TRAVDOC Travel Docwnentation B
1BUSLIC Business Lic.-nse B
CITY OF CUPERTINO
1
*A ACE/AC
FUR
f.1TY Of -_-_ -
--
CUPEkTtNO FEE St�HEDUL
Quantity Fee ID Fee Description Fee Permit Type
-Group
AIR FURN/AC
__CONDITIONING _ _ -
1BCAIRHAN Commercial ASC Units<= 1 O CFM B
1MCRAA Commercial 1\/[ech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential fo ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outict. Comm/Resid
1BRENLkERHAN Residential A C units <= 1 Ok CFM B
1Residential Mech Repair/alt/add M
1BSEISMICR Seismic Resic.ential B
J
JEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRA7VDOC Travel Documentation B I
1BUSLIC Business Lic:nse B
d
ENTER
PROJECT
s ` ! c m d m 5 m
c a
4.Use Solid Wall Systems(Includes SIPS,ICFs,&Any Non-Stick Frame Assembly)
-
a.FJgors -
*�--
2 -._ 7b.Walls 22
EDc.Roofs 2- 2 —
5.Reduce Pollution Entering the Home from the Garage
❑ a.Tightly Ssal the Air Barrier between Garage and Living Area D —
❑ b.Install Garage Exhaust Fan OR Build a Detached Garage D i
❑ 6.Design Energy Heels on Trusses(75%of Attic Insulation Height at Outside Edge of Exterior Wall) 0 1
❑ 7.Design Roof Trusses to Accommodate Ductwork ' D 1
B.Use Recycled-Content Steel Studs for 90%of interior Wall Framing I D 1
9.Thermal Mass Walls:516-Inch Drywall on All Interior Walls or Walls Weighing me re than 4D Iblcu.ft 0 1
10.Install Dverhangs and Gutters
--— — --a.Minimum 16-Inch Overhangs and Gutters
❑ b.Minimum 24-Inch Overhangs and Gutters D 1
otal Points Available in Structural Building Frame and Envelope=361 D 1
E.EXTERIOR FTIMH Points.Available Per Measur-
Lj
1.Use Recycled-Content(No Virgin Plastic)or FSC-Certified Wood Decking 0 2
2 Install a Rain Screen Wall System 0 2
❑ 3.Use Durable and Noncombustible Siding Materials 0 1
❑ 4.Select Durable and Noncombustible Roofing Materials 0 2
Total Points Available in Exterior Finish=71 0
F.INSULATION Points Availabl>Per Measure
1,Install Insulation with 75%Recycled Content
❑ a.Walls and/or Floors --o- - 1
—2b.Cetlinos 0 -
2 install Insulation that is Low-Emitting(Certified Section 01350)
❑ a.Walls and/or Floors
❑ b.Ceilinos 1
❑ 3.Inspect Quality of Insulation Installation before Applying Drywall 0 ! 1
Total Points Available in Insulation=51 D
G.PLUMBING
I Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points).
❑ e.Insulate HM Water Pipes from Water Heater to Kitchen 0
❑ b.Insulate All Hot Water Pipes 0 1 1
❑ c.Use Engineered Parallel Piping 0 1
❑ d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0 _ 1
❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop 0 1 _ 2
❑ f.Use Central Core Plumbing 0 1 1 2
❑ 2.Install Only High Efficiency Toilets(Dual-Flush or 5128 gpi) 0
Total Points Available in Plumbing=Total 121 0 1
H.HEATING,VENTILATION&AIR CONDITIONING I Points Available Per Measure
❑ 1.Design and Install HVAC System to ACCA Manual J,D,and S Recommendation; � 0 1 4
�-Install Sealed Combustion Units
Vo a.Furnaces D 2
❑ b.Water Heaters 0 2
3.Install Zoned,Hydronic Radiant Heating with Slab Edge Insulation 0 1 1
4.Install High Efficiency Air Conditioning with Environmentally Responsible Pet gerants I 0 1
5.Design and Install Effective Ductwork
❑ a.install HVAC Unit and Ductwork within Conditioned Space 0
❑ b.Use Duct Mastic on All Duct Joints and Seams 0 __ 1
❑ c.Install Ductwork under Attic Insulation(Buried Ducts)
❑ d.Pressure Balance the Ductwork System
❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy 0 1
6.Install High Efficiency HVAC Filter(MERV 6+) 0 1
❑ 7.Don't Install Fireplace or install Sealed Gas Fireplaces with Efficiency Rating N d Less Than 6D% 0 1
using CSA Standards
B.Install Eflactive Exhaust Systems in Bathrooms and Kitchens
❑ a.Install ENERGY STAR Bathroom Fans Vented to the Outside _—
❑ b.All Bathroom Fans Are on Timer or Humidistat 0
❑ c.Install Kitchen Range Hood Vented to the Outside D 1
S.Install Mechanical Ventilation System for Cooling(Maximum 4 Points)
❑ a.Install ENERGY STAR Calling Fans&Light Kits in Living Areas&Bedrooms 0 1
❑ b,Install Whole House Fan with Variable Speeds 0 — __1
❑ c.Automatically Controlled Integrated System _ 0—1_ 2
❑ d.Automatically Controlled Integrated System with Variable Speed Control I 3
10,Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House Ventilatign System That Meets ASHRAE 622 FD 2
❑ b.install Air-to-Air Heat Exchanger that meets ASHRAE 62.2 p i Z
❑ 11.Install Carbon Monoxide Alarm(s) 1 0 1
Total Points Available in Heating,Ventilation and Air Conditioning=3D1 0 j
C 2007 Build It Green Single_Fami y GresnPoint Checklist 2007 Version Facie 2 of 4
'ENTER PROJECT
• e NAME
P
Enter descri ion here,and enter points available for measure in appropriate categories to he right
-- --- . ---------
❑ Errtar desviption_here,and enterpointsavailable for measure inappropriate retegodesfo_he fight -- ----- - -� --- - — --- A --0---.- -- - -----0--- --i
❑ Enter desoription here,and enter points available for measure inappropriate categories to fie right --___ 0 0 D 0 D
- - - i o 0 0 0 0 0
❑ Enter description here,and ender points available for measure inappropriate categories to:he right ---.__-_ -___ _0 _ 0 1
-- Build It Green Checklists and —I
4.innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up to a (Guidelines
maximum combined total of 20 pts.See Innovation Checklist for suc ested measures,using the link to the ri ht. I_—_
El Innovation in Community:Ender description here,and enter points available for-measurea appropriate categories to the right 0— 0 0 -�_D D 0 _l
❑ Innovation in Energy:Enter description here,and ender points available for measure in ap xopriate categories to the right 0 D 0 0 D D
- - - —--
❑ Innovation in IAOMealth:Enter description here,and enter points available for measure it appropriate categories to the right 0 0 0 0 D. 0
0 0
❑ Innovation in Resources:Enter description here,and enter points available for measure it appropriate categories to the right. D 0 - 0
Innovation
D
❑ Innovation in Water.Elder description here,and enter points available for measure m app opriate categories to the right _ _— D -D D -�-0 D 0 J
TSI Avatlable Poirds in Other-43 0
SUMMary
Total Available Points in Spec fic Categories` 4+ 196+ 142+ 66+ 143+
Minimum Points Required in Specific Categories O 30 5 6 9
Project Eras net�yk met the,f.tI.vving recommended rnindr-n-ri requirements-
-Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% taaste diversion by weight
J2-X15°io-above-T-rtl e-24
-Ili:Incorporate GreenPoint Rated Checklist into blueprint.
-14inimum points in specific categories:
-Energy(30 points)
-IAOlHea/th(5 points)
-Resources(6 points)
-iNater(9 points)
r....r.....�•— -�------------."rte""r-
Pao2 4 of 4
02007 Build It Green
Single Famil, GreenPoint Checklist 2007 Version