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10050057 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1148 SCOTLAND DR CON TRACTOR:VALLEY HEATING& PERMIT NO: 10050057 COO_ING 0 DINER'S NAME: MARTIN D RADWIN 1171 N 4 TH ST DATE ISSUED:05/05/2010 .NER'S PHONE: 4082571572 SAN JOSE,CA 95112 PHONE NO:(408)294-6290 ❑ LICENSED CONTRACTOR'S DECLARATION BUI'�DING PERMIT INFO: BLDG r ELECT r— PLUMB r License Classr2�11 0� Lic.# MECH RESIDENTIAL COMMERCIAL r Contractor V4Dat I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE FURNACE (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 performance of the work for which this permit is issued. Sq.I t Floor Area: Valuation:$3074 1 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 permit is issued. APN Number:36228011.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply (' with all non-point source regulations per the Cupertino Municipal Code,Section I s s u ed b DateY �� 9.18. Sinnature Date RE-ROOFS: ❑ OWNER-BUILDER DECLARATION All r)ofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspcction, the following two reasons: 1,as owner of the property,or my employees with wages as their sole compensation, Sign iture of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, _ Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I ha ve read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will maiirtain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Hea Ith&Safety Code,Sections 25505,25533,and 25534. 1 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 Worker's Owl ier i d a nt: r\ Compensation laws of California. If,after making this certificate of exemption,I Date: (� become subject to the Worker's Compensation provisions of the Labor Code,I must 7 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hei eby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Len Jer's Name correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter Len Jer's Address ur the above mentioned property for inspection purposes.(We)agree to save i iify and keep harmless the City of Cupertino against liabilities,judgments, co,,.,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply I un ierstand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Lia used Professional Signature Dat CITY OF CUEERTINO 7 ITEMS OF 22 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36228C11. 00 DATE ISSUED. . . . . . . : 05/05/ 2010 RECEIPT #. . . . . . . . . BS000C10330 REFERENCE ID # 10050057 SITE ADDRESS 1148 SCOTLAND DR SUBDIVISION . . . . . . CITY CUPER-INO IMPACT AREA . . . . . . OWNER MARTIN D RADWIN ADDRESS 1148 :SCOTLAND DR CITY/STATE/ZIP . . . : CUPER-INO, CA 95014 RECEIVED FROM . . . . : VALLE:' HEATING & CO CONTRACTOR ATKIN:SON, THOMAS LIC # 141 COMPANY . . . . . . . . . . : VALLE'' HEATING & COOLING ADDRESS 1171 IJ 4 TH ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE (408) :294-6290 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---- ------ ---------- ---------- --------- 1BCBSC VALUATION 3, 074 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 3, 074 . 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 1 . 00 63 . 00 0 . 00 63 . 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 2-32 . 50 0 .00 232 . 50 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL C "�``- T "" `S —7 CITY OF "UPERTINO FURNYWE/AC CITY OF CUPEkTINO PERMIT APPLICATION FORM APN# 5/ � l � �� Date: Building Address: Owner's Name: Phone#: Contractor: Phone#: V l � r a 1 � ,�� Fax Contract4r License#: Cupertino Business License#: Contact: Phone#: 7r ^ Fax Building Permit Info: Elect Plumb Mech u Residential Commercial ❑. Job Description: For Reside tial Installations: Attic ❑ lst floor 2nd floor ❑ Adhere to minimum setback requirement For Commercial Installations: Replacement same weight ❑ A3ditional weight (structural talcs) ❑ Structural Calculations required for new installation New installation Planning Approval Required ❑ Cost of Project: Type of Construction(Usage Class): v Strapped 0 On Platform ❑ BondedEl New Location ❑ Replacement [� Valuation: Green Building: Must attach Green Building Check list to this application !`ITTt T /1 T1 �Y7 TTT T TTS T t� CITY OF CL PERTINO FURNACE/AC CITY Of CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Grou 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 C Zeck M 1MFR=<100 Fumace Syst<=10Dk BTU install or M relocate ea forced-;tir/gravity type furnace/burner, incl ducts/vents attached to such appliance up to and include 100,000 B1u/h 1MFRN>100 Furnace Syst> 100k BTU install or M relocate ea forced-iir/gravity type furnace/bumer, inc 1 ducts/vents attached to such appliance over 100,000 Btu/h 1EPERMITFEE Electric Permit Fei; E 1MPERMITFEE Mechanical Permi:Fee M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Document,,.tion B 1BUSLIC Business License B _1 ENTE R tROJECT ( C= dC C m II c 1 c rj C5 m +� 1 v - 4.Use Solid Wall Systems(Includes SIPS,ICFs,&Any Non•Stick Frame Assembly) ❑ a.Floors ❑ b.Walls 0 — —--— - ❑ c.Roots D - 2- - — 5.Reduce Pollution Entering the Home from the Garage ❑ a.Tightly Seal the Air Barrier between Garage and Living Area u— 1 ❑ b.Install Garage Exhaust Fan OR Build a Detached Garage 0 I 1 ❑ 6.Design Energy Heels on Trusses(75%of Attic insulation Height at Outside Edge of Exteric r Wall) 0 1 ❑ 7.Design Roof Trusses to Accommodate Ductwork I D ! 1 ❑ B.Use Recycled-Content Steel Studs for 9D°/.of interior Wall Framing I 0 ! 1 S.Thermal Mass Walls:51BAnch Drywall on All Interior Walls or Walls Weighing more than 4[Iblcu.ft D I 1 10.Install Overhangs and Gutters - — - ❑ - a.Minimum i6-Inch Dverhangs and Gutters - D ❑ b.Minimum 24-Inch Overhano_s and Gutters 0 1 Total Point Available in Structural Building Frame and Envelope=361 D I E.EXTERIOR FINISH ( Points Available Per Measure LJ 1.Use Recycled-Content(No Virgin Plastic)or FSC-Certified Wood Decking I 0 I 2 ❑ 2.install a Rain Screen(Nall System I 0 I 2 3.Use Durable and Noncombustible Siding Materials D 1 1 ❑ 4.Select Durable and Noncombustible Roofing Materials D 2 Total Points Available in Exterior Finish=71 D F.INSULATION ( I Points Available Per Measure ! 1.Install Insulation with 75%Recycled Content ❑ a.Walls and/or Floors 0 1 —❑ b.-Cellinos - 2.install Insulation that is Low-Emitting(Certified Section 01350) ❑ a.Walls andlor Floors 0 ❑ b.Ceilings 1 ❑ 3.Inspect Quality of Insulation Installation before Applying Drywall I D i 1 Total Points Available in Insulation=51 D 1 G PLUMBING ! Points Available PBT Measure 1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points) 1 ❑ a.Insulate Hot Water Pipes from Water Heater to Kitchen D ❑ 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 ❑ 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 gpf) I 0 I 4 Total Points Available in Plumbing Toted 121 0 I H.HEATING,VENTILATION&AIR CONDITIONING I I Points Available Per Measure ❑ 1.Design and Install HVAC System to ACCA Manual J,D,and S Recommendations 0-T-, 4 2.Install Sealed Combustion Units 1 a.Fumages 2 b.Water Heaters 0 2 3.install Zoned,Hydronic Radiant Heating with Slab Edge Insulation I 0 I 1 1 4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1 5.Design and Install Effective Ductwork ❑ a.Install HVAC Unit and Ductwork within Conditioned Space I 0 _3 F1 b.Use Duct Mastic on All Duct Joints and Seams 4f � _ 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 ED 6.install High Efficiency HVAC Filter(MERV 6+) ! 0 1 ❑ 7.Don't Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rating Not Less Th an 60% 0 1 using CSA Standards B,install Effective Exhaust Systems in Bathrooms and Kitchens ❑ a.install ENERGY STAR Bathroom Fans Vented to the Outside 0 -1 ❑ b.All Bathroom Fans Are on Timer or Humidistat D — ❑ c.Install Kitchen Range Hood Vented to the Dutside 0 1 9.Install Mechanical Ventilation System for Cooling(Maximum 4 Points) ❑ a.Install ENERGY STAR Ceiling Fans&Light Kits in Living Areas&Bedrooms ❑ b,Install Whole House Fan with Variable Speeds ❑ c.Automatically Controlled Integrated System _ D __ 2 ❑ d.Automatically Controlled Integrated System with Variable Speed Control 0 3 10,Install Mechanical Fresh Air Ventilation System(Maximum 3 Points) ❑ F.Any Whole House Ventilation System That Meats ASHRAE 62.2 _ 0 _2 ❑ b.install Air-to-Air Heat Exchanger that meets ASHRAE 62.2 0 1 2 11.Install Carbon Monoxide Alarm(s) I 0 I 1 Total Point:Available in Heating,Ventilation and Air Conditioning=301 D 1 ©2007 Build It Green Single Family GreanF Dint Checklist 2007 Version Paoe 2 0l4 POE description here,and enlet pints maillablee for measure in appropriate categories to the right 0 D D _Enter description here,and enter points available for measure in appropriat categories tother ght. D 0 D D D D _ -- - - - - F-0 — Enter description here,and enter pomts availablefor measure in appropriate categories to the right 0 0 - D D D — — — -— -- _ ❑ Enter description here,and enter points available for measure in appropriate categories to the right D D_ D _D D 0 j ---- -- -- - "--- -_- —---- ----- --- I--- re — - 4.Innovation:List innovative measures that meet the green building object ves of the Guidelines.Enter up to a Build It Gen Checklists andGuidelines maximum combined total of 20 pts.See Innovation Checklist for su 9estec measures,using the link to the right. _ -- -- - El Innovation in Community:Enter description here,and enter points available for•maesurs in approp late categories to the fight 0 D D -11_0 0 D ❑ Innovation in Energy:Enter description here,and enter points available for measure in appropriate:ategones to the right. D D D D I D D ❑ Innovation in Mftafth:Enter description here,and enter points available for measure in appropf,ate categories to the right 0 ❑ Innovation in Resources:Enter description here,and enter points available for measure in appropr ate Categories to the right 0 0 0 0 0 0 ❑ Innovation in Nater.Enter descripfion here,and enter points available for measure in appropriate c itegories to the right.— _ __ D ----— - ---_ — Total Available Points in Other=43 0 -'--- — — Tott.1 Available Points in Specific Categories' 4+ 196+ 142+ 66+ 143+ Mlinimt;m Points Required in Specific Categories 10 I 30 5 6 9 7asra}ect hnot yet met the farrawing recommended micrrm[rm r9gL irements: re — _ -Total Project Score or t Least 50 Points -.Rep/u,irecf measures: -A3a: 501110 waste diversion by weight J2:I SRio-above—T-itl=_-24 -Aft:Incorporate GreenPoint Rated Gnecklist into blueprints -Minimum points in specific categories: -Energy(30 points) -IAO/Health(5 points) -Resources(5 points) -Water(9 points) 02D07 Build It Green Single Family GreanPD'-ft Checkiist 2DD7 Version, Peon-4 of 4 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTO / SUBC'ONTRACTOR LIST JOB ADDRESS: PERMIT OWNER'S NAME: PHONE# GENERAL CONTRACTOR: �/'G� �G� BUSINESS LICENSE# ADDRESS: // /1/ CITY/ZIPCODE: ' Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONT 'FORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Date Please check applicable subco ractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date