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14050058CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7899 ROBINDELL WAY CONTRACTOR:'TBi)T BE PERMIT NO: 14050058 OWNER'S NAME: TENG JUNBIN AND TAN YAN XI DEWI SOE V� DATE ISSUED: 05/08/2014 OWNER'S PHONE: 6502482526 er PHONE NO: JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ LICENSED CONTRACTOR'S DECLARATION WALL INSULATION ON ALL EXTERIOR WALLS ( DRILL �{ License Class Lic. # �S �� 3 AND �� g ors Date FILL BLOW IN CELLULOSE) R -13 Contractor I hereby affirm that I am licensed under the provisio of C apter 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 APN Number: 36219025 00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT WIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIr'?'18fi 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 DA ROM LAST CALLED INSPE T N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in of the costs, and expenses which may accrue against said consequence Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 918. (� RE- ROOFS: being installed. If a roof is Signature Date 1 All roofs shall be inspected prior to any roofing material installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUIL ER 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 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, Business & Professions Code) I, 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 I 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, Sections 5505, 2 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age Date: 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 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, I 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. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender'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 upon 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 CUPERTINO F-1 NFW CONCTRITCTTON CONSTRUCTION PERMIT APPLICATION 66 b� COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ou (408) 777 -3228 • FAX (408) 777 -3333 • buildi— ng0leupertino.org Sd ADDITION n r ALTERATION / TI 1 1 REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS Q � p g1 N Pt LL- WM (N �N # � � 19 O z5-- OWNER NAME \uw(Qi Tfw1Ei PHO `50)2,,19 -2S2,61 EMAIL • ^ (1,•,1 m STREET ADDRESS �V�PI { �'G0Z IG,N ,DS7L4, CITY, STATE,zIP cup�*•,p- TINO 1.+ is cfs-011 FAX CONTACT NAME �, ■ C U r.y ( �'C\j�j" PHO S/O coN STREET ADDRESS 13 5( S S. rye .+-yj RAAGENT T. CITY, STATE, ZIP ^ i c.H N � CIO 4y ,30.E 7 ❑ OWNER ❑ OWNER-BUILDER ❑J OWNER ❑ CONTRACTOR RACTTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTNAME LICENSE NUMBER Q� LICENSE TYPE Q j� BUS. LIC # U COMPANY NAME kN HnMra &MAI y, FAX S1D X29' 30� STREET ADDRESS i r / C /+I S� J V CITY, STATE, ZIP C Q w' D d ,,1 / PHONE ,0 y ARCHITECT/BNGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK WALL IKOVL dri P-13 AJ.J, �� aYZ- W S EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYP& ' OCC. SQ.FT. 777TIl ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH H ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDIT ION? ❑ NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL# ONO PLANNING APPROVAL LETTER IS THE BLDG AN [3 YES EICHLER HOME? 13 NO ;.:,It$GE Y P TAL VALUATION: 00� e+S` By my signature below, I certify to each of the following: I am the property owner or authorized ag to act on the property owner's b al£ I have read this application and the information I have provided is correct. I ave read the Description of Work and erify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building co s ctio authorize representatives of Cupertino to enter the above-identifiedpropepty tion purposes. pt T/7 O Signature of Applicant/Agent: Date: SUPPLEMENTAL INk"TION RECWRED P, , 'CHECK TYPE .... ROUTING SLIP OVER THE COUNTER ❑ B JILDINGPLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building =. permit for new building. ��XPRESS ❑ PLANNING PLAIQ REVIEW -. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ® sTANOnn . ❑ aBilc WORKS _ form if any Hazardous Materials are being used as part of this project. cE ❑ DEPT Copy of Planning Approval Letter or Meeting with Planning prior to '`❑ ❑ ` _ submittal of Building Permit application. JOR SANITARY SEWER DISTRICT .ENVIRONMENTAL .❑ HEALTH BldgApp_201 Ldoc revised 06121111 7 L CITY OF CUPERTINO 1w►Y""' W FF.F. F.CTTM A TnR — RI TILLING DIVISION ADDRESS: 7899 robindell way i P' DATE: 05/0812014 REVIEWED BY: Mendez APN: BP #: "VALUATION: 1$5,000 *PERMIT TYPE: Building Permit Select a Misc Bldg /Structure or Element of a Building PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du I @X USE: p hr's PENTAMATION PERMIT TYPE: WORK I wall insulation r -13 all exterior walls SCOPE 0111 "r 1'lumi; 1T sp, Li NOTE: This estimate does not include fees due to other Departments (i.e. vianning, FUD11C works, rare, aamiary Sewer "iureeu, aLhuui . _ L- --- ('hart the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 Eff. 7,/1,13) i P' QTY /FEE MISC ITEMS Plan Check Fee: Ra $0.00 Select a Misc Bldg /Structure or Element of a Building 11hewh. 1'1c Clec m I rn Lh, "c "k hr's nrrt Fee" 1'lumi)h I'ermif Fee. Nr:m z i'z-e: $0.00 0111 "r 1'lumi; 1T sp, Li 01h,,,,r 1 io , LYt1'(J. Lj Permit Fee: Hourly Only? ® Yes (F) No $0.00 Suppl. Insp. Fee: Reg. 0 OT F0701 NOTE: This estimate does not include fees due to other Departments (i.e. vianning, FUD11C works, rare, aamiary Sewer "iureeu, aLhuui . _ L- --- ('hart the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 Eff. 7,/1,13) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: Reg. ®OT 0.0 hr's $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ® Yes (F) No $0.00 Suppl. Insp. Fee: Reg. 0 OT F0701 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Cor Z:s't?`W,110�1 KU. 0 Work Without Permit? 0 Yes Q) No $0.00 Advanced Planning, Fee: $0.00 hours $278.00 Inspections ISTINSP Inspection, Hourly G %i °vcrl l:ocl. >zrrilatic>n Fees: Strong, Motion Fee: IBSEISMICR $0.50 F-0-57 hrs $44.00 Admin. /Clerical Fee IADMIN Bldg, Stds Commission Fee: 1BCBSC $1.00 tS.? $1.50 $322.00 TOT AL $323.50 Revised: 04/01/2014 STATE OF CALIFORNIA ENVELOPE - INSULATION; ROOFING; FENESTRATION 11 F 1_ CEC- CF -6R- ENV -01 Revised 08/09 CALIFORNIA ENERGY COMMISSION INSTALLATION CERTIFICATE CF -6R- ENV -01 Envelope — Insulation; Roofing; Fenestration (Page 1 of 4) Site Address: Enforcement Agency: Permit Number: i',05005g If more than one person has responsibility for installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check boxes require to be checked to ensure the mandatory measures have been met. 's a Description of Insulation "" 1. RAISED FLOOR �� G f Material: npnim Rntt Brand Name: UltratOUC T IVckness (inches): 5 -3/4" Thermal Resistance (R- Value): R -1 g § 150(d): Minimum R -13 insulation in raised wood -frame floor or equivalent U- factor. 2. SLAB FLOOR/PERIMETER Material: Brand Name: Thickness (inches): Thermal Resistance (R- Value): Perimeter Insulation Depth (inches): ❑ § 150(1): Water absorption rate for the insulation material alone without facings is no greater than 0.3 %; water vapor permeance rate is no greater than 2.0 perm/inch and shall be protected from physical damage and UV light deterioration. 3. EXTERIOR WALL a. Insulation Type (e.x. Batt, Loose Fill, Spray Foam) D n . Park Cellulose b.. Insulation Type (e.x. Batt, Loose Fill, Spray Foam) i 1l • - a. Thermal Resistance (R- Value): R -13 b. Thermal Resistance (R- Value): Spray/Loose fill) (inches): 3. fill) Installed Actual Thickness Contractor's min installed weight/ft' lb (inches): 3.5" _4nufacturer's installed weight per square foot to achieve Thermal Resistance (R- Value) § 150(c): Minimum R -13 insulation in wood -frame wall or equivalent U- factor. Exterior Foam Sheathing (rigid Insulation) Material: Thickness (inches) 4. FOUNDATION WALL Material: Thickness (inches): Brand Name: Thermal Resistance (R- Value) Brand Name: Thermal Resistance (R- Value): 5. CEILING Batt or Blanket Type: Brand Name: Motjntain Fiber Loose Fill Type: Cellulose Thermal Resistance (R- Value): R -38 Spray Foam Type: Brand Name: Installed Actual Thickness (inches): 10.5" Contractor's min installed weight/ft2 1.35 lb Vnufacturer's installed weight per square foot to achieve Thermal Resistance (R- Value): § 150(a): Minimum R -19 insulation in wood -frame ceiling or equivalent U- factor. 6. ATTIC ROOF INSULATION AND /OR ATTIC RADIANT BARRIER Material: Brand Name: Material: Brand Name: Thickness (inches): Thermal Resistance (R- Value): ❑ § 118(a): Insulation installed meets Standards for Insulating Material. 2008 Residential Compliance Forms August 2009 STATE OF CALIFORNIA ENVELOPE — INSULATION; ROOFING; FENESTRATION r CEC- CF -6R- ENV -01 Revised 08/09 CALIFORNIA ENERGY COMMISSION INSTALLATION CERTIFICATE CF -6R- ENV -01 Envelope — Insulation; Roofing; Fenestration (Page 4 of 4) Site Address: Enforcement Agency: Permit Number: Company Name: (Installing Subcontractor or General Contractor or Builder /Owner) Advanced Home Energy Re lbl&P Res sib e P son's Signature: C at in AN CS Date Signed: Position With Co p y (Title): 877873 g / - Agent i I 2008 Residential Compliance Forms August 2009