09100161 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 938 MILLER AVE CONTRACTOR:ATLAS-TRILLO HVAC PERMIT NO:09100161
OWNER'S NAME: WEST VALLEY PRESBYTERIAN CHURCH 1965 KYLE PARK CT DATE ISSUED: 10/23/2009
ER'S PHONE: 4082530735 SAN JOSE,CA 95125 PHONE NO:(408)286-8931
❑ LICENSED CONTRACTOR'S DECLARATIONI—
/ ^� BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# t/�C G �/ MECH r
/y � RESIDENTIAL COMMERCIAL
Contractor- //l�5 �/!� �V Date ��`���''
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE 2 WALL HEATERS
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the Sq.Ft Floor Area: Valuation:$2000
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37541008.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the �.. /G�Z S"
granting of this permit. Additionally,the applicant understands and will comply Issued Date:
with all non-point source regul ti ns per the Cupertino Municipal Code,Section
9.18.
Signature / Date -. "-�C`
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
G OWNER-BUILDER DECLARATION installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: Signature of Applicant: Date:
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE
I hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirements under Chapter 6.95 of the
declarations: California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain a Certificate of Consent to self-insure for Worker's compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Compensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should I store or handle hazardous material.
performance of the work for which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I have and will maintain Worker's Compensation Insurance,as provided for by contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Section 3700 of the Labor Code,for the performance of the work for which this Health&Safety Code Sections 25505,25533,and 25534.
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall Owner or
not employ any person in any manner so as to become subject to the Worker's Date: A`-
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must CONSTRUCTION LENDING AGENCY
forthwith comply with such provisions or this permit shall be deemed revoked. I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued(Sec.3097,Civ C.)
APPLICANT CERTIFICATION Lender's Name
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Address
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
i nify and keep harmless the City of Cupertino against liabilities,judgments,
c. ,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
7 ITEMS OF 21 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 37541008 . 00
DATE ISSUED. . . . . . . : 10/23/2009
RECEIPT #. . . . . . . . . BS000009024
REFERENCE ID # . . . : 09100161
SITE ADDRESS . . . . . : 938 MILLER AVE
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . :
OWNER WEST VALLEY PRESBYTERIAN CHURC
ADDRESS 938 MILLER AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, C 95014-4641
RECEIVED FROM . . . . : TRILLO RENOVATIONS
CONTRACTOR TRILLO, STEVE LIC # 4269
COMPANY ATLAS-TRILLO HVAC
ADDRESS 1965 KYLE PARK CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE (408) 286-8931
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 2, 000 . 00 1 . 00 0. 00 1 . 00 0 .00
1BSEISMICR VALUATION 2, 000 . 00 0 .50 0 .00 0 . 50 0 .00
1EPERMITFE FLAT RATE 1. 00 42 .00 0 .00 42 . 00 0 .00
1MPERMITFE FLAT RATE 1 . 00 42 .00 0. 00 42 . 00 0 . 00
1MRRAA UNITS 2 . 00 126 . 00 0 . 00 126. 00 0 . 00
1PPERMITFE FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 .00
1TRAVDOC FLAT RATE 1. 00 42 . 00 0.00 42 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 295.50 0 . 00 295 .50 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
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Contact: phone 4: e*b 735
Fax.
Buildinc,Pen-nit Info:
Elect Plumb [3--- Mech
Residentiall��
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Job Description:
For Residential Installations:
Attic ❑ I" floor 2nd floor El
Adhere to minimum setback requirement E]
For Commercial Installations:
Replacement same weight ` Additional weight (structural calcs) ❑
iL_
Structural Calculations required for new installation El
New installation Planning Approval Required El
Cot f Project: Type of Construction (Usage Class):
_t�h
1"S77apped F-1 On Platform F-1 Bonded (— New Location ❑ Replacement
-,/aluatlon:
g=reen Building: Nfiast attacli Green Building Check 'list to this appHeatica
'CITY OF CUPERTINO
FURNACE/AC
,'"I TY OF
C up, T�T I FEE SCHEDULE
1 7,H---e UT-) It- Descrip f-I cm P--7, Trit Type
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Coli irita ercia I cpair A-J L a-i `--1 J d
,-a 11-catin-
heatin1g,cooling,"absorption -3r
evaporative cooling system,iucl
---------.------------jnstallation-of-c-ontrols-i-egulated-b--k,fthlsl----
code.
I-T\/1 C.RE PALT Commercial for the repair of alt/add to -11\4
ea heating apphance,refrilgeration
unit,cooling uin*t,VAV boxes,
absorption unit or ea heathing, cooling
11---1 In
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 uiu*t heater.
IPGASCOM Commerical for ea gas piping System P
1-4 outlets
lBPGAS For each gas piping system of 5 or P
more per outlet.
IMCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed¬Lilicl 111 an appliance
permit.
IBSEISMICO Commercial Seismic B
INERRAA Residential Rep air/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heatinig,cooling,absorption or
evaporative'cooling system,a-icl
installation o--L"controls regulated by
this code.
IS T,J S HT R Residential ranstall/'Reiocatc ea I --iq
suspended heaterjecessed -wail htr, or
floor mounted Linit heater.
\- in L
- tf�sidential for the ' s-�alljl-clocal-e'
-eP I a cem.,e n.-'- o Ic a appliance-ler,.
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CITYOF CUPERTIN D
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PGASCON/f onlmellcal f(--,r ca gas piping SystT
I
i-4 outlets
-IPG-AS-UL -S- -R(--,—si-d6-n-ti-'dFfor,-----a-gas-pipingr s-viste-
of 1-4 Outlets
I BP GAS For each gas piping system of 5 or P
more per outlet. Connn/Resid
IBREMAIRHAN Residential A/C units <= l0k CFM B
IMRRAA Residential Mech Repair/alt/add M
IBSEISMICR Seismic Residential B
IEPERMITFEE Electric Pe=t E
IMPERNIITFEE Mecham*cal Permit M
IPPERMITFEE Plumbing Permit P
ITRAVDOC Travel Documentation B
IBUSLIC Business License B
ItNTER PROJECT NAME
4.Use Solid V11"all Systems(includes SIPS,ICFs,1 Any Non-Stick Frame Assembly)
❑ a.Floors 7)-7
13.Walls
❑ r,.Roots
i.'Reduce Pollution Entering line Home from the Garage
a.Tightly Seal the Air Barrier between Garage and Living Area
Install Garaae Exhaust Fan OR Build a Detached Garage i 0
F-0 9.Design Energy Heals on Trusses(75%of Attic Insulation Heiqht at Outride Edge of Exterior Well) ......
❑ 7.Design Roof-Trusses to Accommodate Ductwork
0 3.Use RLcycied-Content Steel Studs for 90%of interior Wall Framing
17 1.3.Thermal Mass Wails:5/8-inch Drywall on All late6nr%FVaIL--,r Wrills'Afteighing more 1han 10 lblcii..t,
10.Inslall Overhangs and Gutters
-I.Minimum It)Inch Overtiarim ind(-,I
b.Minimum 24-Inch Overhangs and Gutters
37k TAERIOR�InRIMSH
-ij,lul,
1.Use Recycled-Content(No`Grain Plastic)or?�C[,,_rtifited A[Dod Decking
2.Install a Rain Screen'Nall System
3.Use Durable and Noncombustible Siding Materials
1 4.Select Durable and Noncombustible Roofino Materials
Total Points Available in il)aenor 1=mish 71 Q
�F,INSULATION Points Available Per M-Hisure
1,Install Insulation with 75%Recyr:lsd C.rfient
El a.Walls and/or Floors
2 Install Insulation that is Low-Firnitting(Certified Section 01 S50)
❑ a.Walls and/or Floors
❑ b.Ceilinas 0 -7
❑ 3.inspect Quality of Insulation Installation before Applying Drywall j ,)
Total Points Available in Insulation C)5i
G.PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points)
[] a.Insulate Hot Water Pipes from Water Heater to Kitchen D 1 --T�
El b.Insulate All Hot Water Pipes 0 1 1
❑ c.Use Engineered Parallel Piping 0
El d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop D
❑ a.Use Structured Plumbing with Demand Controlled Circulation Loop 0 1 2
❑ I.Use Central Core Plumbing 0
❑ 2.Install Only High Efficiency Toilets(Dual-Flush or S1.28 gpq 0
Total Points Available in Plumbing=Total 121 0 1
,EL HEATING.VENTILATION&AIR CONDITIONING I Points Available Per Ittleasure
❑ 1.Design and install HVAC System to ACCA Manual J,D,and S Recommendations 0 4
2.install Sealed Combustion Units
❑ a.Furnaces 0-1 1
❑ b.Water Heaters 2
❑ 3.Install Zoned,Hydronic Radiant Heating with Slab Edge insulation 0
Ll 4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants o
5.Design and Install Effective Ductwork
❑ a.Install HVAC Unit and Ductwork within Conditioned Space
❑ b.Use Duct Mastic on All Duct Joints and Seams I 0
❑ c.Install Ductwork under Attic Insulation(Buried Ducts) 1-0
❑ d.Pressure Balance the Ductwork System 0
❑ 9.Protect Ducts during Construction and Clean All Ducts before Occupancy 0
❑ 6.Install High Efficiency HVAC Filter(MERV 6+) 0
Ei 7.Don't Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rating Not Less Than 50% 0
using CSA Standards
8.Install Effective Exhaust Systems in Bathrooms and Kitchens
F-1 a.Install ENERGY STAR Bathroom Fans Vented to the Outside
❑ b.All Bathroom Fans Are on Timer or Humidistat
❑ c.Install Kitchen Range Hood Vented to the Outside
9.Install Mechanical Ventilation System for Cooling(Maximum 4 Points)
❑ a.Install ENERGY STAR Ceiling Fans&Light Kits in Living AF62S&Bedrooms 0
F-1 b.install Whole House Fan with Variable Speeds
❑ c.Automatically Controlled Integrated System D 21
❑ d.Automatically Controlled Integrated System with Variable Speed Control 0
10.install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House Ventilation System That Meets ASHRAE 62.2 9
b.install Air-to-Air Heat Exchanger that meets ASHRAE 31', 0
1,'Install Carbon filiDnoxide Alarms) 0 1
Total Points Available in Heating,Ventilation and Air Conditioning=301 0
,� -2
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
XPERTINO
Building Department
JOB ADDRESS: PERMIT #
OWNER'S NAME:Ci U'4. PHONE # -1—S-3 c3 -73
GENERAL CONTRACTOR: FAX # 7 7-z - Z
I am not using any subcontractors:
Signature Date
Please check applicable subcontr 76rsan�d 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