09080034 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18661 STARRETT CT CONTRACTOR:BLUE MOUNTAIN PERMIT NO:09080034
AIR
WNER'S NAME: WINNIE CHOW 707 ALDRIDGE RD STE B DATE ISSUED:08/07/2009
OWNER'S PHONE: 4082574822 VACAVILLE,CA 95688 PHONE NO:(707)451-81 l 1
❑ LICENSED CONTRACTOR'S DECLARATION !
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Cl —Z Lie.# S 8 66 c§' r-
.7—
.7 , MECH RESIDENTIAL COMMERCIAL
Contractod J Date O � � Zc,1J)9
JOB DESCRIPTION: ADD AIR CONDITION TO SYSTEM 3/4/TON
I hereby affirm that I am licensed un he 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 declaration:
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:$5700
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:37526022 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 relatir g 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 ,��� .9
granting of this permit. Additionally,the applicant understands and will comply Issued by: �"" Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
1 ,r� RE-ROOFS:
gnat a Date 0` -!a&rj All roofs shall be inspected prior to any roofing material being installed. If a roof is
U _ installed without first obtaining an inspection,1 agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant:_ Date:
I hereby affirm that I am exempt from the Contractor's License Law for one A
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 compensatic n,
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 have 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 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will 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,Se io s 25505,25 3,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized ager Dater
permit is issued.
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 Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 hereby affirm that there is a construction lending agency for the pertormance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097•Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address __-
1 certify that 1 have read this application and state that the above information is
^rrect. 1 agree to comply with all city and county ordinances and state laws relati ng
luilding construction,and hereby authorize representatives of this city to enter
on the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify 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.
Signature______ Date _
CITY OF CUPERTINO
FUWIACE/AC
CUPEI�TINO PERMIT APP]--JICATION FORM
APN #
Date:
Building Address: e4/ r
Owner's Name: Phone#:
Yoh- S 7 y� � z
Contractor: Phone#: 707- yW- el
10 L) r 1�� -7%)�lue ax7 /
Contractor License#: Cupertino Business License#:
Contact: Phone#: 7,27- yet-/- ge t i/
` 1 O-t:. e cc 9 Fax#:
Building Permit Info:
Elect Plumb Mech
Residential Commercial
Job Description: / II
d C 4-0
���e� � �.� 13 S-�eA �- �
For Residential Installations:
Attic ❑ I" floor [] 2°d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight(structural talcs) ❑
Structural Calculations required for new installatior. ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
Strapped H On Platform Bonc ed New Location ❑ Replacement
Project Size: Express ❑ Standard Large ] 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. 6Z2 _
Revised 01/07/09
CITY OF C UPERTINO
a FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description. Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= l0k CFM B
1 MCRAA Commercial Mec a Repair/alt/add M
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICO Seismic Commer;ial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 PGASRES 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<= l0k CFM B
1 MRRAA Residential Mech Repair/alt/add M
l 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
1 MPERMITFEE Mechanical Perrr.it M
r
1 PPERMITFEE Plumbing Permit P
' 1 TRAVDOC 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 mist be
shown and referenced on the Project
Plans See below
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, (no-e) 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/Spe(;.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 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, (NoteiSpec.) A-3 1 point
3. Energy Star Refrigerator, Note,'S ec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS j 40 points
3
l b 6i ^VU 6"-C-/
Z_
Plan Review Process Work Book Page-12-Revised 3/25/08
INPUT ResDurres Energy AD
I.Windows
1.Install Energy-Efficient Windows
1 Energy pt y=yes 0
a.��-p
Energy pts y=yes 0
b.Low-Ettassi�rity{Trow-E) 0
c.Low.Conductivity Ffaimes Energy pts y=yes
2.Install Low Heat Transmission Glazing Energy pt y=yes 0
. 1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Dud Mastic on AN Duct Joints ?Energy pts Y=Yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside I IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy i 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 D
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/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 stoves/inserts 1 IAQ/Health pt y=yes 0
b. InstaIVReplace 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 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
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
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0