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15030179S, CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20195 STEVENS CREEK BLVD CONTRACTOR: HUETTIG & SCHROMM, PERMIT NO: 15030179 INC OWNER'S NAME: WDT-CUPERTTNO 431 BURGESS DR STE 200 DATE ISSUED: 05/15/2015 OWNER'S PHONE: 6503222121 MENLO PARK, CA 94025-3478 PHONE NO: (650) 322-2121 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL -I Zyo6� KEYENCE - OFFICE TENANT IMPROVEMENT (3737 SQ License Class Lic. N �_ FT). Contractor S Date MAY I hereby affirm that 1 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: 1 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: $203500 performance of the work for which this permit is issued. 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 APN Number: 31624047.00 Occupancy Type: pis 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. 1 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 by:. Date: granting of this permit. Additionally, the applicant understands and will comply Issued with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. �j�f y RE -ROOFS: Signature 6�%%p Date I c"C�(� All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that 1 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) 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. 1 will 1 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, Sect' rs 25505, 25533. d 25534./Vf Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agen 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 • building(c�cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION :K ALTERATION® ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT S .E � C tel) LV • e i t�itvFi� APN a -(>4 /'r OwNERNAME 97T (& ftlho L1.�/ PHONE 059��n - 7-12t G/_. //7 / ErMA1L/fdn � kS rb trt18s STREET ADDRESS Ot J� wss br -( j� bO t (` / C 4 CIT} �St�FjOIP �j� /VPHIONE ( r c+A 9 �a25 �,ON40 322- 5029 CONTACT NAME %3 �.��G� r� C' G.G_G_t E-MAIL �jQ-p.�y kis «+'rc+!—\ r ss -co STREET ADDRESS CITY, STATE, ZIP Fp ❑ OWNER ❑ OWNER -BUILDER 119OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ffen Ne u VYI �c ste.r LICENSE NUMBER �J ^ �� b G `� LICENSE TYPE BUS. LIC H COMPANY NAMEG /_rbc t �r o ►M (n�. E-MAIL ken @ s ro �r`tres . ��tt FAX lo�0 322-r. STREET ADDRESS �3 r Bur 2ss Dr. # 20o CITY, STATE, ZIP�� /O DQ r, /4 n 02, ` ` k �+4 `� Lf 5 PHONE Coyo 3 22 - 2 r 2r >al ARCHITECT/ENGINEER NAME LICENSE NUMBER 17-tt BUS. LIC # t L� IS ,/ NAME t, \ TS MAIL e1 T C� I�V � i FAXIS,35v-LkO STREET ADDRESS 4,, uN ?-Oz CITY, STATE, ZIP W%CO C PHONE t -3Sb- Ob DESCRIPTION T�r`•JOF wORKTMetA ¢-(r,-t-I bNS •� �- 't SANT ,Vt-KC or- LAO?-Gc ST I IL1 Cn't20Of ,kS SCO /�LE'� h e cSS� Fi l Llf�W EXISTING USE� k(_ 1r PROPOSED USE Q �N�� CONSTR. TYPE 7 `TOTAL # STORIES USE TYPE OCC. SQ.FT. VALUATION {$) EXISTG IdE8 NEW FLOOR AREA N /A DEMO AREA { `t _ jJ NET AREA BATHROOM REM.. KITCHEN REMODEL AREA OTHER C REMODEL AREAIr r , PORC H AREA DECK AREA rv�� TOTAL DECK/PORCH AREA GARAGE AREA: DETACH A ❑ ATTACH # DWELLING UNITS: �JA SECOND UNIT ❑ YES FIE'UGADDED?;ONO SECONDSTORY ❑ YES ADDITION? {�'iJ0 /� PRE -APPLICATION YES ff YES, PROVIDE COPY OF PLANNING APPL # ❑ O PLANNING APPROVAL LETTER IS THE BLDG ANS YES EICHLER HOME. ❑ 0 i l '/ ,v� r/sia,�a�l��!!�/�������%�/��ii', // /// / T TAL VALUATION: d By my signature below, I certify following: Iam the pe y owner orauthorized agent to act on the property owner's behalf. I have read this application and the information I orcect. I have r ad th Description of Work and verify it is accurate. I agree to comply with all applicable local VeaFchot'tUhe ordinances and state laws relatinction. I ayth epresentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED — New SFD or Multifamily dwellings: Apply for demolition permit for building(s). Demolition is required to issuance ce ofbuilding ,,/i��'%�'/e li�l�%.,,��/���/��/'� / �t " %i/a��a�%!/rr; , a n lrl�/,, , „iji /' ; �% J ./%,,fig existing permit prior permit for new building. Bldgs: Provide Hazardous Materials Disclosure _Commercial a completed Materials are being use as art of this project. form if an Hazardous Mat s e d Copy of Planning Approval Letter or Meeting with Planning prior to j✓ /���ri��/f /1�, rl,, �/i�ll�, — submittal of Building Permit application. , , ,,���//,ij,,��f//,,jr�/,/i oi�',,,H/�iiri/��/i!%;%,,, %I % !i%/1i /ll//%� ; ✓lr"" ',��i �r%%��� BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO j FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20195 Stevens Creek Blvd DATE: 03/27/2015 REVIEWED BY: Sean PC FEE ID APN: BP#: `VALUATION: 1$203,500 PERMIT TYPE: Building Permit PLAN CHECK TY E: Tenant Improvement PRIMARY Commercial Building USE: IBTIPLNCK PENTAMATION 1 B TI PERMIT TYPE: 19 WORKOffice Tenant Improvement 3737 s ft). SCOPE Suppl. Insp. Fee:Q Reg. Q OT OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 3,737 $2,405.96 IBTIPLNCK $3,268.84 IBTIINSP $3,268.84 Suppl. Insp. Fee:Q Reg. Q OT 1 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 0 Work Without Permit? Yes E) No $0.00 TOTALS: 3,737 $2,405.96 l rot r, I $3,268.84 Strong Motion Fee: IBSEISMICO M CH, HOURLY , O Yes 0 Nb PLUMB, HOURLY Yes No : ,Yes CLEC, I C1 IRLX • " " , 49F�rlr, 1'(r�rr C,�h��rl� f'(rrrrth l r r,t ('hrcl, f"ae�,.�k Select a Misc Bldg/Structure or Element of a Building 19 �rl ,n I7, C':' I nli/ 1'Pc 11Lc rc9`i}lr /,"'c'. ofocl. H , h, 1,/, l C )t/w< t�'bdYnb Li L_ 0( v,']' U r ln1 ).Ll W", iti f , <c hr v). N11 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,405.96 Select a Misc Bldg/Structure or Element of a Building 19 Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,268.84 Suppl. Insp. Fee:Q Reg. Q OT 1 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 0 Work Without Permit? Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential E) Building or Structure i l rot r, I Strong Motion Fee: IBSEISMICO $56.98 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $9.00 11T8'i6I,S,1 $5,740.78 $0.00 �T4A�FL $5,740.78 Revised: 02/14/2015 I;IT14 ECEIVED jUt- 2 7 2015 T CwP OV -P Aj i CUPERTINdy-24L CONTRACTOR / SUB C NTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: PERMIT # d s l '7,9 OWNER'S NAME:) PHONE # GENERAL CONTRACTOR: 4t.itN `("44 i+ ;;7 BUSINESS LICENSE # Z 1j b ADDRESS:+37/ ) -, ^ �, �' "S" ' " U -9' CITY/ZtPCODE: -v I/- r-, *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 SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. ft - I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: (� �.�. It /4f, -S t w e VICO PAs14try Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork C,4iPeS'-r6/dC- [;tMb�LI-JNC, Cement Finishing Electrical Excavation Fencing Flooring / Carpeting oP-cwAP4,) c�'TY FLtxoo (6ve-eimc 2,:S-� 2 cT Linoleum / Wood Glass / Glazing CLJv;'S1C- GLASS Ji N C 5- (B 4- 0 Heating T 2, C_ H(CtAkw 1 CAL 2 q9 Insulation Landscaping Lathing Masonry Painting / Wallpaper IE'l F rz 1 6 C)'3 Paving Plastering Plumbing 3 Roofing Septic Tank Sheet Metal Sheet Rock i N ©v' T1 Otis Tile (� �.�. It /4f, -S t w e VICO PAs14try Owner / Contractor Signature Date CUP RTINO CALGREEN NON-RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL r 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin cu _ ertino,orIke PURPOSE: The non-residential provisions of the 2013 CalGreen Code outline planning, dell d development methods that include environmentally responsible site selection, building design, building siting a velopment to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the,txae of conse J indoors, outdoors and in wastewater conveyance; outlines means of achierial conse rce efficiency; and outlines means of reducing the quantity of air contamin s Irl e��iidir r')(Josm Project Name:I AM, 8 TEW"fjIfUIP EMENT Project Address: 20195 STEVEN�SC�WLV 9420 was reg w a t5v ,;IVY r Project Description: INTERIOR REMODEL FOR FUTURE TENANT Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. MANDATORY FEATURE OR MEASURE The project meets all the requirements of Divisions 5.101 through 5.508 5.106.1 Storm water pollution prevention. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been designed, specific to its site, conforming to the State Storm water NPDES Construction Permit or local ordinance, whichever is stricter, as is required for projects over one acre. The plan should ti o I ss by storm water run-off and/or wind erosion, of sedi / particulate matter air pollution. Column 2 Column 3 Project Verification muirements 0 NIA Page 1 0I79 CaWreen Non -Rev Checkli,v.doc retnsed 01123114 6.1013.4 Bicycle parking. Comply with Sections 5.106.4.1 and 5.106.4.2; or meet local ordinance, whichever is stricter. 1 0 N/A ❑ 5.106.5.2 Designated parking. Provide designated parking for any combination of low -emitting, fuel-efficient and carpool/van pool vehicles as ® N/A ❑ shown in Table 5.106.5.2. (NO PARKING SPACES ADDE 5.106.8 Light pollution reduction. Outdoor lighting systems shall be 0 N/A ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones 1 — 4 as defined in Chapter 10 of the California Administrative Code; and 0 N/A ❑ 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM -15-11; and I ® N/A I ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or 0 N/A ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how 0 N/A ❑ site grading or a drainage system will manage all surface water flows. 5.201.1 Scope. The California Energy Commission will continue to adopt I ❑ I ❑ mandatory building standards. 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1 .1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. I 0 N/A I ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the I ® N/A I ❑ building projected to consume more than 100 gal/day. j 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater 0 N/A than 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot-water boilers with energy input > 500,000 Btu/h. Page 2 of 9 CalGreen Bron -Res Checklisrdoe revised 01/23/14 (NO PARKING 5.106.41.1 Short -Term bicycle parking. If the qualified project is SPACES ADDE ) anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers-by, © N/A ❑ for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two -bike capacity rack. 5.106.4.1.2 Long -Term bicycle parking. For qualified buildings with over 0IV/A ❑ 10 tenant -occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low -emitting, fuel-efficient and carpool/van pool vehicles as ® N/A ❑ shown in Table 5.106.5.2. (NO PARKING SPACES ADDE 5.106.8 Light pollution reduction. Outdoor lighting systems shall be 0 N/A ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones 1 — 4 as defined in Chapter 10 of the California Administrative Code; and 0 N/A ❑ 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM -15-11; and I ® N/A I ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or 0 N/A ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how 0 N/A ❑ site grading or a drainage system will manage all surface water flows. 5.201.1 Scope. The California Energy Commission will continue to adopt I ❑ I ❑ mandatory building standards. 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1 .1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. I 0 N/A I ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the I ® N/A I ❑ building projected to consume more than 100 gal/day. j 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater 0 N/A than 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot-water boilers with energy input > 500,000 Btu/h. Page 2 of 9 CalGreen Bron -Res Checklisrdoe revised 01/23/14 5.303.1.2 Excess consumption. A separate submeter shall be provided for any tenant within a new building or within an addition that is projected ®N/A ❑ to consume > 1,000 gal/day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate values shown in Table 5.303.2.3. © N/A ❑ Exception: Building that demonstrate 20 -percent overall water use reduction. 5,303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall © ❑ ❑ apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water -conserving fixtures or 0 N/A ❑ 2. Utilizing non -potable water systems. Q N/A ❑ 5.303.6 Standards for plumbing fixtures and fittings, Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code ❑ (GPC), and shall meet the applicable standards referenced in CPC Table 1401.1 and CalGreen Chapter 6. 6otoi ,br Water 5.304.1 Water budget. A water budget shall be developed for landscape ® N/A ❑ irrigation use. 5.304.2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least ® N/A ❑ 1,000 sq.ft. but not more than 5,000 sq -ft., separate submeterrs or metering devices shall be installed for outdoor potable water use. 5.304,3 Irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft. of cumulative landscaped area, install irrigation controllers and sensors which ❑X N/A ❑ include the following criteria, and meet manufacturer's recommendations. 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as Q N/A ❑ weather conditions change. 2. Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates © N/A ❑ with the controller(s). Soil moisture -based controllers are not required to have rain sensor input, Weatler Zest#alCe Ord Mo­tulr+rwMangernenfi ; 5.407.1 Weather protection. Provide a weather -resistant exterior wall and foundation envelope as required by California Building Code Section 1403.2 0 N/A LJ Eland Califomia Energy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent.' Page 3 of Ca]Caven Mon -Res Checkhsl.doc revised 01123114 6.407,2 Moisture control. Employ moisture control measures by the following methods; 5.407.2.1 Sprinklers, Prevent irrigation spray on structures, 0 N/A ❑ 5.407.2.2 Entries and openings. design exterior entries and/or openings 0 N/A ❑ to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and 0 N/A ❑ wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following: 1. An installed awning at least 4 ft in depth, 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection. 5.407.2.2.2 Flashing. Install flashings integrated with a drainage ❑X N/A ❑ plane. GOrlsttIt tlUrl 1 # ESC G MQn# �ISpQSc"IN a IC "R Cyt, inq "; ,: 5.408.1 Construction waste management. Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408.1.1, 5.408.1.2, or 5.408.1.3; or meet a X❑ ❑ local construction and demolition waste management ordinance, whichever is more stringent. 5,408.1.1 Construction waste management plan. Submit plan per this ❑ section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of ❑ ❑ construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408. 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square ❑ foot of building area may be deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5.408.1.4 Documentation. Provide documentation of the waste ❑ ❑ management plan that meets the requirements listed in Section 5.408.1.1 through 5,408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land ❑X N/A ❑ clearing shall be reused or recycled. Baii�ditng nd Itltnterartc atperafan 5,410.1 Recycling by occupants. Provide readily accessible areas that serve the entire building and are identified for the depositing, storage and collection ® ❑ ❑ of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the [] N/A ❑ design and construction processes of the building project. Commissioning requirements shall include items listed in Section 5.410.2. Page 4 of CalCireen Non Res C'hecklist.doc revised 01123114 5.410.2.1Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in u N/A ❑ Section 5.410.4. 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems 0 N/A listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of ® N/A ❑ the building project and shall include items listed in Section 5.410.2.3. 5.410.2.4 Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each component, system and system -to -system interface in accordance with the 0 N/A ❑ approved plans and specifications. 5.41:0.2.5 Documentation and training. A Systems manual and systems operations training are required. © N/A ❑ 5.410.2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall ® N/A ❑ include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type andlor system 0 N/A ❑ shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and 0 ❑ reporting recommendations for post -construction phases of the building N/A project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303.1. 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall include, as applicable to the project, the systems listed in Section ® N/A ❑ 5.410.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards 0 N/A ❑ on each system. 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a building or space is operated for normal use, the system should be balanced in accordance with the procedures defined by ® N/A ❑ national standards listed in Section 5.410.3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for ® N/A performing mese services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of 0 N/A 1:1guaranties/warranties for each system prior to final inspection. 5.410.4.5.1 Inspections and reports. Include a copy of all inspection verifications and reports required by the enforcing agency. 1 0 N/A ❑ Page 5 of 9 CezlGreen Non -Res Cheeklist.doe reused 01/23/14 5.503.1 Install only a direct -vent sealed -combustion gas or sealed wood - burning fireplace or a sealed woodstove and refer to residential requirements ® N/A ❑ in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase II emission limits. ❑X N/A ❑ 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component Fo ❑ openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or ❑ SCAQNID Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and other Fo ❑ requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall comply with Table 5.504.4.3 unless more stringent local limits apply. Fn ❑ 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted MIR Limits for ROC in Section 94522(x)(3) and other requirements, including prohibitions on use of Fo ❑ certain toxic compounds and ozone depleting substances (CCR, Title 17, Section 94520 et seq). 5.504.4.3.2 Verification. Verification of compliance with this section shall be provided at the request of the enforcing agency. FO ❑ 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards ❑ listed in Section 5.504.4.4. 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute Fn ❑ Green Label program. 5.504.4.4.2 Carpet adhesive. All carpet adhesive shall meet the of Table 5.504.4.1. Forequirements ❑ Page 6 of 9 C."alGreen Non -Res C'hecklisf.doe revised 011/23/14 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for ❑ formaldehyde as specified in Table 5.504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section Fo ❑ shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following standards listed in Section 5.504.5.3. 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one Fz] ❑ of the following standards listed in Section 5.504.4.6. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and El air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced F El by ordinances, regulations or policies of any city, county, city and county, Califomia Community College, campus of the California State University or campus of the University of California, whichever are more stringent. IrldCS"C►l" Moisture ani i2dori, Cr�ntrol 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203 ® N/A ❑ and Chapter 14.1. Air *haust,. 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California El Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with demand control ventilation, CO2 sensors and ventilation controls shall be © N/A ❑ specified and installed in accordance with the requirements of the latest edition of the California Energy Code, CCR, Title 24, Part 6, Section 121(c).' Enrrironmidntai Comfc�rk 5.507.4 Acoustical control. Employ building assemblies and components ® N/A ❑ with STC values determined in accordance with ASTM E 90 and ASTM E 413. 5.507.4.1 Exterior noise transmission. Wall and floor-ceiling assemblies making up the building envelope shall have an STC of at least 50 and exterior windows shall have a minimum STC of 30 for any of the building 0 N/A ❑ locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4,2 Interior sound. Wall and floor-ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of ❑ at least 40. Page 7 of C,alGrem ikon -Res Checklisrdoc revised 01/23/14 5.508.1 Ozone depletion and greenhouse gas reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration 0 N/A equipment that does not contain CFCs. 5.508.1.2 Halons, Install fire suppression equipment that does not contain❑ Halons. F0- I � Page 8 of COlGreen Mon -Res Checklist.doc revised 01/23/14 CALGREEN SIGNATURE DECLARATIONS Project Name: COLDWELL BANKER CUPERTINO Project Address: 10105 S. DE ANZA BLVD. Project Description: INTERIOR REMODEL FOR EXISTING TENANT SECTION I — DESIGN VERIFICATION Complete all lines of Section 1 — "Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as ad pted by the City of Cupertino. `"it /A) Owner's Signature I n Owners Name (Please Print) 0r Y00t/l Pin (f )�2'}— Design Professional's Signature Calvin Lum - Vitae Architecture DeAkjn-erofessional's Name (Please Print) se Professional responsible for CalGreen compliance Paul Hockett - Vitae Architecture (C-12415) Name of License Professional responsible for CalGreen compliance (Please Print) pnocKenLvitaearcnitecture.com Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Date 03 z� S Date 2q - I Date 415-356-6400 Phone Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance pa-ge 9 of 9 Ca1Given Non -Res C'hecklist.doe revised 01123/14