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10050198 CITY OF CUPERTINO 13UILDING PERMIT BUILDING ADDRESS: 22636 SILVER OAK WAY CONTRACTOR:TBD-TO BE PERMIT NO: 10050198 DETERMINED VNER'S NAME: JEFF PAGE DATE ISSUED:05/26/2010 OWNER'S PHONE: 4089963648 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JO 3 DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic.# Ir'STALL GAS DECORATIVE APPLIANCE AT W DODBURNING Contractor Date FIREPLACE ARE TO BE ALTERED I hereby affirm that I am licensed under the provisions of Chapter 9 (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 Ft Floor Area: Valuation:$5000 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 AFN Number:34212060.22636 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 Is med by: E�OD , Z�/P Date: �' granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: mature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is in;tailed without first obtaining an inspection,I agree to remove all new materials for in;pection. OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I lave read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's m aterial. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the a r contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. %ill maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533 and 25534. Section 3700 of the Labor Code,for the performance of the work for which this C caner or authorized ag t: Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall L_ not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. v ork's for which this permit is issued(Sec.3097,Civ C.) 1 ender's Name APPLICANT CERTIFICATION bender's Address 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 to building construction,and hereby authorize representatives of this city to enter 3n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION .demnify and keep harmless the City of Cupertino against liabilities,judgments, costs,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. _ / Signatur '' Date�� 12 ' I L' r Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CUPERTINO CONTRACTOR/ UBC ONTRACTOR LIST JOB ADDRESS: - PERMIT OWNER'S NAME: ,�� - 'l; C� c � PHONE# �C�� '�", ��- BUSINESS LICENSE# GENERAL CONTRACTOR: ``�� CITY/ZIPCODE:� c� CA,!5c ADDRESS: � *Our municipal code requires all businesses working in the oity to have a City of Cupertino business license. EDULED NO BUILDING FINAL OR FINAL OCCUPANCY INSI'ECSION(S) WILL BE HAVE OBTAINED AHCITY OF CUPERTINO UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAMEBUSINESS 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 Date wner/Con r ctor Signature CITY OF CUPHRTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lit: APN 34212050 .22636 DATE ISSUED. . . . . . . : 05/26/2010 RECEIPT #. . . . . . . . . BS000010497 REFERENCE ID # 10050198 SITE ADDRESS 22636 SILVER OAK WAY SUBDIVISION . . . . . . . CITY CUPER'IINO IMPACT AREA . . . . . . OWNER JEFF FAGE ADDRESS 22646 SILVER OAK WAY CITY/STATE/ZIP CUPERTINO CA, CA 95014-5622 RECEIVED FROM GAYLA PAGE CONTRACTOR TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AM01JNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---- ------ ---------- -- 00 1BCBSC VALUATION 5, 000 . 00 1. 00 0 .00 1 . 00 0. 1BSEISMICR VALUATION 5, 000 . 00 0 . 50 0 .00 0 . 50 0 . 00 1. 00 443 . 00 0 .00 443 . 00 0 . 00 1FIREPLFAB EACH ---------- ---------- ---------- --- TOTAL PERMIT : 444 . 50 0 .00 444 . 50 0 . 00 ,n of CITY OF CUPERTINO CUPEkTINO GENERAL 13UILDING PERMIT APPLI(7ATION FORM I Cab I APN# �� a �� Date: � •/G-7 J Building Address: (Vq Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes No HOA: Exterior work only) Yes ❑ No ❑ Ifes, rovide letter from HOA Owner's Name: ( r Phone#: Contractor: Chin �-�,�� - "� -1 Irl Phone: Fax: � S-9_ O Contractor License#: eA-CA 6L.c 5 93 Sc701 Cupertino Business License#: Contact: r, C�. Phone:l-fU�S- ��`� (c;Z.( ' Fax: UZ3 Ut a44�� Residential Commercial Job Description: J/,O-� � (�txtAU�� n Building Permit Info: Bldg D Elect P--." Plumb M� Mech Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B [I• �-- Valuation: g Square Footage: Project Size: Express 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: �p For help, contact Build it Green at www.buildit reen.or Revised 07/14/09 � . CITY OF CUPERTINO Carr OF GENERAL BUILDING APPLICATION CUPEI�TINO FEE SCH�:DULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM ACOUSTICAL REVIEW IACOUSFDW SFDWL/Dupl,.x New B IACOUSRESAD SFDWL/Dupl-,x-Addition/Alteration B l ACOUSCOM Multi-Family/commercial B CHIMNEY'S 1 CHIMNEY Chimney B 1 CHIMNEYR Chimney Repair B FENCES 1 FENCE>6FT Non-masonry over 6 ft in height B 1 FENCEMAS>6 Masonry, ove-6 ft in height B FIREPLACES 1FIREPLMAS Fireplace Ma,;onry B 1 FIREPLFAB Fireplace Pre.Fabricated/Metal B 1 FLAGPOL>20 Flag pole (ov;r 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS 1 FOUNDREP Foundation Repair B 1PILECAST Pile Foundation Cast in place concrete B 1 PILEDRIV Pile Foundation Driven (steel, pre- B stressed concrete 3 of 5 CITY OF CUP'ERTINO PPLICATION n C.� of GENERAL BUILDING A CUPEf�T1NO FEE SCHEDULE Fee Descripti c)n Fee Permit Type Quantity/Sf Fee ID Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stuc(;o application 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1 WINMEWSTR New Window-structural shear B wall/masonry I includes plan ck fee) Electrical Permit Fee E 1 EPERMITFEE 1 MPERMITFEE Mechanical Pormit Fee M Plumbing Permit Fee P 1PPERNiITFEE g IELCPLNCK Stand Alone Electric Pln Ck(hourly) E 1 MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pln Ck(hrly) P 1 STPLNCK-(3 Hr Min Standard Pla:i Check (when no EMP) B when not over counter) hourly-stand alone Cal Bldg StEndards Commission Fee B ALL PERMIT 1BCBSC TYPES � 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Coinmercial B 1 TRAVDOC Travel &D)cumentation B 1 BUSLIC Business License B 5 A5 Green Points Rating Syaterr for Remodeling Projects Due to the diversity of remodeling project types, assigning a"total poin:s"value to a project to be considered environmentally friendly is not feasible.However,25 measures have been highlighted to signify tl•at every effort should be made to incorporate them into your projects. These items have been chosen based upon their impact on tie 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. INFUT s A.Site 1.Recycle Job Site Construction&Demolition Waste 65%=1 point;75%= 2 points;60 =4 points uF to 4 Resource pts 0 2.Salvage Reusable Building Materials 4 Rescurce pts y=yes 0 3.Remodel for Mixed Use,Adaptive Reuse,and Historic Preservation 4 Resc urce pts y=yes 0 4.Protect Native Soil 2 Resc urce pts y=yes 0 5.Minimize Disruption of Existing Plants&Trees 1 Resc urce pt y=yes 0 6.Implement Construction Site Stormwater Practices 2 Resc-urce 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 es 0 10,Install High-Efficiency Irrigation Systems 2 Resource pts es 0 11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0 i 1 f 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 u)to 5 Resource pts 0 2.Use Recycled Content Aggregate 2 Res)urce pts y=yes 0 3.Insulate Foundation/Slab before backfill 3 EnE:rgy pts y=yes 1 0 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 10) up to 10 Resource pts. 0 3.Use Wood I-Joists for Floors and Ceilings 2 Relcource pts y=yes 0 4.Use Web Floor Trusses 2 Res ource pts y=yes 0 5.Design Energy Heels on Trusses 6"or more 2 En;rgy pts y=yes 0 6.Use Finger-Jointed Studs for Vertical Applications 2 Re:ource pts y=yes 0 7.Use Engineered Studs for Vertical Applications 2 Re:ource pts y=yes 0 B.Use Recycled Content Steel Studs for Interior Framing 2 Re,ource pts y=yes 0 9.Use Structural Insulated Panels(SIPs) a.Floors 3 En:rgy pts y=yes 0 b.Wall 3 Enargy pts y=yes 0 G.Roof 3 En:rgy pts y=yes 0 10.Apply Advanced Framing Techniques 4 Re:;ource pts y=yes 0 11.Use Reclaimed Lumber for Non Structural Applications 3 Re;;ource pts y=yes 0 12.Use CSB a.Subfloors 1 Re;:ource pt y=yes0 b.Sheathing 1 Re;,ource pt y=yes 0 ® E 1 d IAWHealth INPUT Energy I.Windows 1.Install Enargy-Efficient Windows 0 1 Enercy pt y=yes a.Double-Panad p b.Low-Emissivity(Low-E) 2 Enerry pts Y=yes 2 Enerrly pts Y= as 0 c.Low.Conductivity Frames p 2.Install Low Heat Transmission Glazing 1 Ener(;Y pt Y= es D i 1 J.Heating Ventilation and Air Conditioning 0 1.Use Duct Mastic on All Duct Joints 2 Energy pts y=yes 0 2.Install Ductwork within Conditioned Space 3 Enei gy pts Y=yes 0 3.Vent Range Hood to the Outside 1 IAQ/-lealth pt y=yes p 4.Clean all Ducts Before Occupancy 2 IAQ Health pts Y=yas 2 Ene-gy pts Y=YeS 0 5.Install Solar Attic Fan p 6.Install Attic Ventilation Systems 1 Ene'gy pt y=yes 4 Energy pts y=Yes p 7.Install Whole House Fan 8.Install Sealed Combustion Units 0 a.Furnaces 3 IAC/Health pts Y=yes 0 b.Water Heaters 3 IAC/Health pts y=yes 9.Replace Wall-Mounted Electric and Gas Heaters with 0 Through-the-Wall Heat Pumps 3 En�:rgy pts y=yes 10.Install 13 SEER/11 EER or higher AC with a TXV 3 En;rgy pts y=yes 0 0 11.Install AC with Non-HCFC Refrigerants 2 Re.ource pts y=yes YG. I -a D Annual Fuel Utilization Eff4cie c (AO)Furnac�--(�v n5 9 XPIV--yes 12.Install 90/o Ann l.` 13.Retrofit Wood Burning Fireplaces p a.Install EPA certified wood stoves/inserts 1 IA0JHealth pt y=yes 1 Er ergy pt Y_-Yes 0 b. InstalVReplace Dampers 0 c,Install Airtight Doors 1 Er ergy pt y=yes 0es 14.Install Zoned,Hydronic Radiant Heating 3 Energy pts Y=Y 0 15.Install High Efficiency Filter 4 IAD/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 IP Q/Health pts y=yes 0 K.Renewable Energy and Roofing 0 1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 10 E nergy pts y=YeS 0 2.Install Solar Water Heating System 0 3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 4.Install Photovoltaic(PV)System to 18 Ener is 0 (1.2 Wi=6 points,2.4 kw=12 points,3,6 kw=18 points) Up 9Y P 0 6.Select Safe and Durable Roofing Materials 1 R;source pt y=yes P 0 7.Install Radiant Barrier 3 I_nergY ts Y=YeS � ® i � L.Natural Heating and Cooling 0 1.Incorporate Passive Solar Heating 5 Energy pts y=Yes P y=yes 0 2.Install Overhangs or Awnings over South Facing Windows 3 E nen9Y is . )-y 1-71 0 3.Plant Deciduous Trees on the West and South Sides 3 E nergy pts y=yes