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15050042CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6756 JOHN DR CONTRACTOR: ALL WEATHER PERMIT NO: 15050042 CONSTRUCTION OWNER'S NAME: VIJAYAKUMAR KULKARNI & ROOPA RAO 615 DUNHOLME WAY DATE ISSUED: 09/10/2015 OWNER'S PHONE: 4086803299 SUNNYVALE, CA 94087 PHONE NO: (408) 708-8603 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ CONSTRUCT ONE STORY ADDITION (692 SQ FT); COVERED License Classy'_ Lic. # �7//(% PORCH (40 SQ FT); INTERIOR REMODEL (160 SQ FT). ContractorW/ !/Ve7Z.lr &Slate 8 1f I hereby affirm that I am licensed under the provisi ns of t4hapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. Sq. Ft Floor Area: N aluation: $75000 I hereby affirm under penalty of perjury one of the following two declarations: i. I have and will maintain a certificate of consent to self -insure for Worker's kPN Number: 36923003.00 Occupancy "I"� pc: Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 permit is issued. PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF P , I SSUANCE OR APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is 180 DAYS t D INSPECT ON. 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 Date: indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 RE -ROOFS: all non -point source rregus per the Cupertino Municipal Code Section 9.18. All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature Date l �� installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 1. 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 HAZARDOUS MATERIALS DISCLOSURE sale (Sec.7044, Business & Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the 2. I, as owner of the property, am exclusively contracting with licensed contractors to California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain construct the project (Sec.7044, Business & Professions Code). compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. I hereby affirm under penalty of perjury one of the following three declarations: Additionally, should I use equipment or devices which emit hazardous air t. I have and will maintain a Certificate of Consent to self -insure for Worker's contaminants as defined by the Bay Area Air Quality Management District 1 will Compensation, as provided for by Section 3700 of the Labor Code, for the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Flealth & Safety Code, Sections 25505, 25533, and 25534. performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Owner or o ' ed agent: /, Section 3700 of the Labor Code, for the performance of the work for which this Date: t/ 2 ° s permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I shall CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's become subject to the Worker's Compensation provisions of the Labor Code, I for which this permit is issued (Sec. 3097, Civ C.) Lender's Name must forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Address APPLICANT CERTIFICATION ARCHITECT'S DECLARATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1-1 CUPERTIN0 I (408) 777-3228 • FAX (408) 777-3333 • buildingecupertino.org ❑ NEW CONSTRUCTION t ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJEC ADDRESS 6 7 5 O r-4 r J [) Q� t t 1r�1�T " V `, APN # /� 73 w OWNERNAME V'r— y � u L I PHONE 40 1 / � J Z�71E-h� CC7 v)�v Tttl M0( O H N �I`p STREET ADDRESS / S� JOHN 1\ V1 CITY, STATE, ZIP ,v P M TT No�� FAX I�i, � 1 - M_ PHONE CONTACT NAME 1n A// (c Y,j,` ►V V V t1 (J �/, ` E-MAIL Y STREET ADDRESS CITY, STATE, ZIP FAX 1-1 OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME J`cT LICENSE NUMBER LICENSETYPE BUS. LIC# COMPANY NAME tLD 1 ^1 �r A E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE /j t)g 76 /1 �CO3 C## Va 'b b /I w ^ K n /,� ARCHITECT/ENGMEER NAME MARK 1(J LICENSE NUMBER BUS. LIC COMPANY NAME � D us r 1� E-MAIL I FAX STREET ADDRESS CJD '7C -� w [� Fp t j /i 7 / �J�/' ` J j� CEJ CITY, STATE, ZIP PHONE DESCRIPTION OF WORK CQa2 �ou ANJ) Eh7STING USE PROPOSED USE CONSTR TYPE # STORIES Q� I1�L USE TYPE OCC. SQ.FT. VALUATION (i) EXISTO AREA r 'r _ y I av NEW OO AREA � Z AREA TOTAL NEI' AREA -. BATHROOM. KITCHEN.OTHER. REMODEL AREA REMODEL L AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: _ D� TACH ,0'ATTACH 78 # DWELLING UNITS: IS A SECOND UNIT [I YES SECONDSTORY []YES BEING ADDED? ❑NO ADDITION? [:]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LEITER IS THE BLDG AN ❑ YES _ CTOT AWA TION: EICHLER HOME? ❑ N . _ 0M 5 By my signature below, I certify to each of the following: I am the property owner or authorized to act on the owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is awl6laTe. I agree to comply with all applicable local ordinances and state laws relating to buildi ns ction. I authorize representatives of Cupertino to enter the above -identified propertyfor inspection purposes. Signature of Applicant/Agent: / :-1 i/�^{"y�/ Date: SUPPLEMENTAL INFORMATION REQUIRED PI AN C1�CIirTIPE ieJAND vER=THE-COUNTER BL�s'DING L „" ' ' New SFD or Multifamily d%;vellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO MW FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 6756 JOHN DR DATE: 05/07/2015 REVIEWED BY: MELISSA PC FEE ID APN: 369 23 003 BP#: *VALUATION: 1$75,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? 0 Yes 0 No I OTC. 0 Yes ®No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK ADD 692 S.F. TO CREATE N FAMILY ROOM N BEDROOM & N LIVING ROOM & 40 S.F. OF SCOPE (N) COVERED PORCH AREA. REMODEL 160 S.F. INTERIOR AREA TO RECONFIGURE o OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (s f.) PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 732 $2,654.00 1R3PLNCK $1,666.00 IR3INSP 1 i r7o, 1 S, !' . _. PME Plan Check: $0.00 Permit Fee: $1,666.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 732 $2,654.00 $1,666.00 MECH, HOURLY ® Yes 0 No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No tlech. Plan C:'he:ckPhurrh. Plan Check Ilec. Plan Check Pluml7. P FIec Permir Fee- Oihcr ilcclr. hisr� )r;zc�r F,°umairrsL-i I - �Other�Ilec.Insp. El ,}!"" h {t. �! 1 2c lwHlh l 111",1 ... 1 i r7o, 1 S, !' . _. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc. ). These fees are based on the preliminary information available and are onlv an estimate. Contact the Dept for addh 7 info. FEE ITEMS (&e Resolution 11-053 E(f 7/1/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,654.00 = s.f. $431.00 Remodel, Other IREMRESOTH Suppl. PC Fee: Reg. OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,666.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (:onstruction Tax: A(Iministrative Fee: Q E) Work Without Permit? Yes E) No $0.00 Advanced Planning Fee: IPLLONGR $102.48 Select a Non -Residential Building or Structure E) 0 Tra,el Ii«c rru.�rYt< r��,�. Stronf,; Motion Fee: IBSEISMICR $9.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $4,435.23 $431.00 TOTAL FEE -T $4,866.23 Revised: 04/01/2015 M DI - Building Department, City Of Cupertino 10300 Torre Avenue Cupertino, ,CA 95014-3255 CUPERTINO Telephone: 408-177-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT # OWNER'S NAME: V"' I /AeH, PHONE# -706 9(go 3 GENERAL CONTRA O BUSINESS LICENSE# 2(fqQ7-:, ADDRESS: 1Cd4j 2-- CITY/ZlPCODE:CA 5;46 �Uur municipal code requires all businesses working in the city to have a City of Cupertido business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCOXT)RACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: V511 -01C.. Signature / -7 Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # v' Cabinets & Millwork Y)L qqn-� c�ho n 40 67S Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing V/ Heating 571f Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving De-rl'n o5go Plastering Plumbing Roofing Septic Tank Sheet Metal V'Sheet Rock C) 01 Tile Owner / Contractor Signature Date c BUILDING ENERGY ANALYSIS REPORT CUPERTINO PROJECT: Building Dep®r&mnt John Drive Additio AUG 3 12015 6756 John Drive REVIEWEu t -OR DUDE COMPLIANCE Cupertino, CA Revieww BV Project Designer: Mak Design Group 3000 Scott Blvd. Suite 108 u M ITTAL ..:: Santa Clara, CA 95054 (408) 905-5699 #3 Report Prepared by: Timothy Carstairs, CEA, HERS, GPR Carstairs Energy Calculations PO Box 4736 San Luis Obispo, CA 93403 (805) 904-9048 RECEIVED AUG 0 5 2015 Job Number: BY — 15-04307 4 102fl F ICE CO"""' HY The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2013 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC —www.energysoft.com. Energ Pro 6.5 by EnergySoft User Number. 6249 ID: 15-04307 41 I TABLE OF CONTENTS I Cover Page 1 Table of Contents 2 Form CF -1 R -ADD -02-E Certificate of Compliance 3 Form RMS -1 Residential Measures Summary 10 Form MF -1 R Mandatory Measures Summary 12 Zone Load Summary 16 EnergyPro 6.5 by EnergySoft Job Number: ID: 15-04307 User Number: 6249 51 A I E OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 1 of 9) Project Name: John Drive Addition Date Prepared: 4/30/2015 This compliance document is only applicable to additions 300 ft` or less, or additions that do not require HERS field verification for compliance. When HERS verification is required, a CF1R-ADD-01 shall first be registered with a HERS Provider Data Registry. Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-ADD-02 and CF2R- ADD -02 Compliance Documents. Possible exemptions from duct leakage testing include: less than 40 ft of ducts were added or replaced; or the existing duct system was insulated with asbestos; or the existing duct system was previously tested and passed by a HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CF1R-ADD-01 must be completed and registered with a HERS Provider Data Registry. Additions or alterations that utilize Closed Cell Spray Polyurethane Foam (ccSPF) with a density of 1.5 to less than 2.5 pounds per cubic foot having an R -value other than 5.8 per inch, or Open Cell Spray Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having an R -value of 3.6 per inch, shall complete and register a CF1R ADD -01 with a HERS Provider Data Registry. 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 shall be met. Temporary labels shall not be removed before verification by the building inspector. A. GENERAL INFORMATION 01 Project Name: John Drive Addition 02 Date Prepared: 4/30/2015 03 Project Location: 6756 John Drive 04 Building Front Orientation (deg): (N) 0 deg 05 CA City: Cupertino 06 Number of Dwelling Units with Additions: 1 07 Zip Code: 08 Fuel Type: Natural Gas 09 Climate Zone: 4 10 Total Conditioned Floor Area (ft) (Addition): 732.0 11 Building Type Single Family 12 Slab Area (ft 2): 0 13 Project Scope: Addition: CFA = 732.0 sqft CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 2 of 9) Project Name: Date Prepared: John Drive Addition 4/30/2015 B. OPAQUE SURFACE DETAILS — Framed (Section 150.2(a)) 01 02 03 04 05 06 07 08 09 10 11 Tag/ID Assembly Type Frame Type Frame Depth (inches) Frame Spacing (inches) Proposed Required Comments Cavity R -value Continuous Insulation R -value U -Factor AppendixJA4 Reference U -Factor Table Cell 1 Floor Wood 2x6 @ 6 in. O.C. 19 0.0 0.037 4.4. -A4 0.037 R-19 Floor Crawlspace 2 Wall Wood 2x4 @ 6 in. O.C. 15 5.0 0.064 4.3. -A4 0.102 R-15 Wall 3 Roof Wood 2x4 @24 in. O.C. 30 0.0 0.031 4.2.1 A20 0.031 R-30 Roof Attic 4 Wall Wood 2x4 @ 6 in. O.C. 0 0.0 0.356 4.3. -Al 0.102 R-0 Wall 5 Wall Wood 2x4 @ 6 in. O.C. 13 5.0 0.068 4.3. -A3 0.102 R-13 Wall CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 5I A i L Ur UALa-UnNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CF1R-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION '"0" CERTIFICATE OF COMPLIANCE CF111-ADD-02-E Prescriptive Residential Additions 300 Ftz or Less, or Additions That Do Not Require HERS Field Verification (Page 4 of 9) Project Name: John Drive Addition Date Prepared: 4/30/2015 E. SLAB INSULATION (Table 150.1-A) 01 02 03 04 05 06 Floor Type Proposed Required Comments Insulation R -value Insulation U -factor Insulation R -value Insulation U -factor • Heated slab floors require mandatory slab insulation (see Table 110.8-A). F. RADIANT BARRIER (Section 150.1(c)2 01 02 Radiant Barrier installed below the roof deck and on all gable end walls Comments All New Roof areas with Attics Radiant Barrier required in this Climate Zone A radiant barrier is required (for Climate Zones 2-15) • Radiant barriers shall meet specific eligibility and installation criteria to receive energy credit for compliance with the Building Energy Efficiency Standards for low-rise residential buildings. Refer to RA4.2.1 • The emittance of the radiant barrier shall be less than or equal to 0.05 as tested in accordance with ASTM C1371 or ASTM E408. For Prescriptive Compliance the attic shall be ventilated to provide a minimum free ventilation area of not less than one square foot of vent area for each 300 ft2 of attic floor area with no less than 30 percent upper vents. Ridge vents or gable end vents are recommended to achieve the best performance. The material should be cut to allow for full airflow to the venting. CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 51Ni E Ui- GHLWUMiviA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification ft GEG-GFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION e CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification (Page 5 of 9) Project Name: John Drive Addition Date Prepared: 4/30/2015 G. ROOFING PRODUCTS (COOL ROOF) (Section 150.1(c)11) 01 02 03 04 05 06 07 08 09 10 11 12 Mass Roof 25lb/ft2or Greater Roof Pitch Method of Compliance Product Type CRRC Product ID Number Proposed Required Initial Solar Reflectance Aged Solar Reflectance Thermal Emittance SRI (Optional) Aged Solar Reflectance Thermal Emittance SRI (Optional) Maximum Maximum Addition Type ft Allowed Allowed Comments Maximum Maximum Calculated Maximum Calculated Maximum U -factor SHGC Calculated Calculated based on based on Allowed ft Allowed ft2 Allowed % Allowed % 732.0 146.4 175.0 36.6 70.0 0.320 0.250 NOTES: • Any roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. H. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(a)1) 01 02 1 03 04 05 06 07 08 Maximum Allowed Maximum Allowed Fenestration Area For All Orientations ftz West -Facing Fenestration Area Only ft The Greater The Greater Maximum Maximum Addition Type ft Allowed Allowed Comments Maximum Maximum Calculated Maximum Calculated Maximum U -factor SHGC Calculated Calculated based on based on Allowed ft Allowed ft2 Allowed % Allowed % 732.0 146.4 175.0 36.6 70.0 0.320 0.250 CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 J I H I r- Ur (_,11LIr Urw4 IH Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION 'w' CERTIFICATE OF COMPLIANCE CF111-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 6 of 9) Project Name: John Drive Addition Date Prepared: 4/30/2015 I. FENESTRATION PROPOSED AREAS AND EFFICIENCIES 01 02 03 04 05 06 07 08 09 10 11 12 13 Tag/ID Ta /ID Fenestration T Type Frame Type Dynamic Glazing Orientation N, S, W, E or Roof Number of Panes Proposed Fenestration z Area ft Proposed West Facing Fenestration Area ft2 Proposed U -factor Proposed SHGC Source Exterior Shading Device Combined SHGC from CFIR-ENV- 03 1 New Non -Metal (N) 2 20.0 0.320 0.25 NFRC n/a 0.25 2 New Non -Metal (NW) 2 10.0 10.0 0.320 0.25 NFRC n/a 0.25 3 New Non -Metal (SW) 2 10.0 0.320 0.25 NFRC n/a 0.25 4 New Non -Metal (W) 2 40.0 40.0 0.320 0.25 NFRC n/a 0.25 14 Total Proposed Fenestration Area 80.0 15 Maximum Allowed Fenestration Area 175.0 16 Compliance Statement Total Proposed Fenestration Area <_ Maximum Allowed Fenestration Area Q Yes ❑ No 17 Total Proposed West -Facing Fenestration Area 50.0 18 Maximum Allowed West -Facing Fenestration Area 70.0 19 Compliance Statement Total Proposed West -Facing Fenestration Area <_ Maximum Allowed West -Facing Fenestration Area 10 Yes ❑ No 20 Proposed Fenestration U -factor 0.320 21 Required Fenestration U -factor 0.320 22 Compliance Statement Proposed Fenestration U -factor <_ Required Fenestration U -factor 12 Yes ❑ No 23 Proposed Fenestration SHGC 0.250 24 Required Fenestration SHGC 0.250 25 Compliance Statement Proposed Fenestration SHGC <_ Required Fenestration SHGC ® Yes ❑ No CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification ILAJ. CEC-CF1R-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 7 of 9) Project Name: John Drive Addition Date Prepared: 4/30/2015 J. SPACE CONDITIONING(SC) SYSTEMS - HEATING/COOLING (Prescriptive section 150.2(b). Alterations to Space Conditioning Systems shall be exempt from HERS verification requirements as prerequisite for use of the CF1R-ADD-02 and CF2R-ADD-02 Compliance Documents. If new space conditioning systems are installed or existing systems are altered and are not exempt from HERS verification, then a CF111-ADD-01 shall be completed and registered with a HERS Provider Data Registry. In each row below for each dwelling unit in the building, check the box that indicates the exemption from HERS verification compliance: ❑ a: space conditioning system was not altered; ❑ b: less than 40 ft of ducts were added or replaced; ❑ c: (exempt from duct leakage testing) if: the existing duct system was insulated with asbestos; ❑ d: (exempt from duct leakage testing) if: the existing duct system was previously tested and passed by a HERS Rater. 01 02 03 04 Dwelling Unit Name SC System Identification or Name SC System Location or Area Served Exemption from HERS Verification HVAC System 1,890 el a ® b ❑ c ❑ d 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 61 A I E OF CALlrORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification , CEC-C17IR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION ®"0" CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ftz or Less, or Additions That Do Not Require HERS Field Verification (Page 9 of 9) Project Name: John Drive Addition Date Prepared: 4/30/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Timothy Carstairs, CEA, HERS, GPR Documentation Author Signature: Company: Carstairs Energy Calculations Signature Date: 4/30/2015 CEA/ HERS Certification Identification (if applicable): / Address: PO Box 4736 Phone: Y City/State/Zip: San Luis Obispo, CA 93403 (805) 904-9048 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Company: Date Signed: Mak Design Group Address: License: 3000 Scott Blvd. Suite 108 City/State/Zip: Phone: Santa Clara, CA 95054 (408) 905-5699 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 RESIDENTIAL MEASURES SUMMARY RMS -1 Project Name John Drive Addition Building Type ❑ Single Family ❑ Addition Alone ❑ Multi Family 10 Existing+ Addition/Alteration Date 4/30/2015 Project Address 6756 John Drive Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 1,890 Addition 732 # of Units 1 INSULATION Construction Type Area Cavity (ft) Special Features Status Floor Wood Framed w/Crawl Space no insulation 1,158 Existing Wall Wood Framed - no insulation 844 Existing Roof Wood Framed Attic R 11 1,158 Existing Floor Wood Framed w/Crawl Space R 19 732 New Wall Wood Framed R 15 368 Rigid=R-5.0 New Door Opaque Door - no insulation 40 New Roof Wood Framed Attic R30 732 New Demising Wood Framed - no insulation 256 New FENESTRATION I Total Area: 218 Glazing Percentage: 11.5%1New/Altered Average U -Factor: Orientation Area(ft2) U -Fac SHGC Overhang Sidefins Exterior Shades 0.32 Status Left (E) 42.0 1.280 0.80 none none Bug Screen Existing Rear (S) 56.0 1.280 0.80 none none Bug Screen Existing Rear (S) 40.0 1.250 0.80 none none Bug Screen Existing Front (N) 20.0 0.320 0.25 none none Bug Screen New Right (NW) 10.0 0.320 0.25 none none Bug Screen New Rear (SW) 10.0 0.320 0.25 none none Bug Screen New Right (W) 40.0 0.320 0.25 none none Bug Screen New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 78% AFUE Split Air Conditioner 13.0 SEER Setback Existing HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status HVAC System Ducted Ducted Attic 6.0 Altered WATER HEATING Qty. Type Gallons Min. Eff Distribution Status Ener Pro 6.5 by Ener Soft User Number: 6249 RunCode: 2015-04-30711:27:27 ID: 15-04307 Pa e 10 of 16 RESIDENTIAL MEASURES SUMMARY RMS -1 Project Name John Drive Addition Building Type ❑ Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 4/30/2015 Project Address 6756 John Drive Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 1,890 Addition 732 # of Units 1 INSULATION Construction Type Area Cavity (ft) Special Features Status Demising Wood Framed R 13 84 Rigid=R-5.0 New FENESTRATION I Total Area: 218 Glazing Percentage: 11.5 New/Altered Average U -Factor: 0.32 Orientation Area(ft2) U -Fac SHGC Overhang Sidefins Exterior Shades Status HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status WATER HEATING Qty. Type Gallons Min. Eff Distribution Status Ener Pro 6.5 by Ener Soft User Number: 6249 RunCode: 2015-04-30T11:27:27 ID: 15-04307 Pa e 11 of 16 2013 Low -Rise Residential Mandatory Measures Summary NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. Exceptions may apply. Review the respective code section for more information. Building Envelope Measures: §I 10.6(a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. § 110.6(a)5: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of § 10-111 (a). § 110.7: Exterior doors and windows are weatherstripped; all joints and penetrations are caulked and sealed. § 110.8(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on the C172R. § 110.8(i): The thermal emittance and aged solar reflectance values of the cool roofing material meets the requirements of § 110.8(i) when the installation of a cool roof is specified on the CF 1 R. § 110.80): A radiant barrier shall have an emittance of 0.05 or less when the installation of a radiant barrier is specified on the CFI R. Minimum R-30 insulation in wood -frame ceiling; or the weighted average U -factor shall not exceed 0.031. Minimum R-19 in a § 150.0(a): rafter roof alteration. Attic access doors shall have permanently attached insulation using adhesive or mechanical fasteners. The attic access shall be gasketed to prevent air leakage. § I50.0(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -value. §150.0(c): Minimum R-13 insulation in 2x4 inch wood framing wall or have a U -factor of 0.102 or less (R-19 in 2x6 or 0.074 maximum U - factor). §150.0(d): Minimum R-19 insulation in raised wood -frame floor or 0.037 maximum U -factor. In Climate Zones 14 and 16 a Class II vapor retarder shall be installed on the conditioned space side of all insulation in all exterior § 150.0(g)1: walls, vented attics and unvented attics with air -permeable insulation. In Climate Zones 1-16 with unvented crawl spaces the earth floor of the crawl space shall be covered with a Class I or Class II § 150.0(g)2: vapor retarder. In a building having a controlled ventilation crawl space, a Class I or Class II vapor retarder shall be placed over the earth floor of §I50.0(g)3: the crawl space to reduce moisture entry and protect insulation from condensation, as specified in the exception to Section 150.0(d). §150.0(1): Slab edge insulation shall: have a water absorption rate, for the insulation material alone without facings, no greater than 0.3%; have water vapor permeance rate is no greater than 2.0 perm/inch, be protected from physical damage and UV light deterioration; and when installed as part of a heated slab floor meets the requirements of § 110.8 150.0 § (q)' Fenestration, including skylights, separating conditioned space from unconditioned space or outdoors shall have a maximum U- factor of 0.58; or the weighted average U -factor of all fenestration shall not exceed 0.58. Fireplaces, Decorative Gas Appliances and Gas Log Measures: §150.0(e)IA: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150.0(e)1B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a readily accessible, operable, and tight -fitting damper or a combustion -air control device. §150.0(e)IC: Masonry or factory -built fireplaces have a flue damper with a readily accessible control. § I50.0(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: §110.0-§110.3: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified to the Energy Commission. §I 10.3(c)5: Water heating recirculation loops serving multiple dwelling units meet the air release valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of § 110.3(c)5. Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appli- § 110.5: ances without an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool ands a heaters. § 150.0(h)1: Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA using design conditions specified in § 150.0(h)2. § 150.0(h)3A: Installed air conditioner and heat pump outdoor condensing units shall have a clearance of at least five feet from the outlet of any dryer vent. § 150.0(i): Heating systems are equipped with thermostats that meet the setback requirements of § 110.2(c). § 150.00)IA: Storage gas water heaters with an energy factor equal to or less than the federal minimum standards shall be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. § 150.00)1 B: Unfired hot water tanks, such as storage tanks and backup storage tanks for solar water -heating systems, have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. For domestic hot water system piping, whether buried or unburied: the first 5 feet of hot and cold water pipes from the storage tank, all piping with a nominal diameter of 3/4 inch or larger, all piping associated with a domestic hot water recirculation system § I50.00)2A: regardless of the pipe diameter, piping from the heating source to storage tank or between tanks, piping buried below grade, and all hot water pipes from the heating source to kitchen fixtures must be insulated according to the requirements of TABLE 120.3- A. § 150.0 J)2B: All domestic hot water pipes that are buried below grade must be installed in a water proof and non -crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. 203 Low -Rise Residential Mandatory Measures Summary §I50.00)2C: Pipe for cooling system lines shall be insulated as specified in §I50.00)2A. Piping insulation for steam and hydronic heating systems or hot waters stems with pressure > 15 psig shall meet the requirements in TABLE 120.3-A. § 150.00)3: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Insulation exposed to weather shall either be rated for outdoor use or installed with a cover suitable for outdoor service. For §150.00)3A: example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation protected as specified or painted with coating that is water retardant and provides shielding from solar radiation that degrades the material. Insulation covering chilled water piping and refrigerant suction piping located outside the conditioned space shall have a Class I §150.00)3B: or Class II vapor retarding facing, or the insulation shall be installed at the thickness that qualifies as a Class I or Class II vapor retarder. Systems using gas or propane water heaters to serve individual dwelling units shall include: a 120V electrical receptacle within 3 feet of the water heater; a Category III or IV vent, or a Type B vent with straight pipe between the outside termination and the §150.0(n)l: space where the water heater is installed; a condensate drain that is no more than 2 inches higher than the base of the installed water heater, and allows natural draining without pump assistance; and a gas supply line with a capacity of at least 200,000 Btu/hr. §150.0(n)2: Recirculating loops serving multiple dwelling units shall meet the requirements of §I 10.3(c)5. §150.0(n)3: Solar water -heating systems and collectors shall be certified and rated by the Solar Rating and Certification Corporation (SRCC) or by a testing agency approved by the Executive Director. Ducts and Fans Measures: All air -distribution system ducts and plenums installed are sealed and insulated to meet the requirements of CMC §601.0, §602.0, §603.0, §604.0, §605.0 and ANSI/SMACNA-006-2006 HVAC Duct Construction Standards Metal and Flexible 3rd Edition. Supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-6.0 (or higher if required by CMC §605.0) or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing (RA3.1.4.3.8). Connections of metal ducts and inner core of flexible ducts are mechanically fastened. Openings shall be sealed §150.0(m)l: with mastic, tape, or other duct -closure system that meets the applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than'/, inch, the combination of mastic and either mesh or tape shall be used. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. Factory -Fabricated Duct Systems shall comply with specified requirements for duct construction, connections, and closures; joints § I50.0(m)2: and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. §150.0(m)3=6: Field -Fabricated Duct Systems shall comply with requirements for: pressure -sensitive tapes, mastics, sealants, and other requirements specified for duct construction; duct insulation R -value ratings; duct insulation thickness; and duct labeling. § I50.0(m)7: All fan systems that exchange air between the conditioned space and the outside of the building must have backdraft or automatic dampers. § 150.0(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers except combustion inlet and outlet air openings and elevator shaft vents. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind but not §150.0(m)9: limited to the following: insulation exposed to weather shall be suitable for outdoor service. For example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation. § 150.0(m)10: Flexible ducts cannot have porous inner cores. When space conditioning systems use forced air duct systems to supply conditioned air to an occupiable space, the ducts shall be § 150.0(m)11: sealed and duct leakage tested, as confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Mechanical systems that supply air to an occupiable space through ductwork exceeding 10 feet in length and through a thermal § 150.0(m)12: conditioning component, except evaporative coolers, shall be provided with air filter devices that meet the requirements of §150.0(m)12. Space conditioning systems that utilize forced air ducts to supply cooling to an occupiable space shall have a hole for the placement of a static pressure probe (HSPP), or a permanently installed static pressure probe (PSPP) in the supply plenum. The §150.0(m)13: space conditioning system must also demonstrate airflow > 350 CFM per ton of nominal cooling capacity through the return grilles, and an air -handling unit fan efficacy < 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Zonally controlled central forced air cooling systems shall be capable of simultaneously delivering, in every zonal control mode, § ] 50.0(m)15: an airflow from the dwelling, through the air handler fan and delivered to the dwelling, of>_ 350 CFM per ton of nominal cooling capacity, and operating at an air -handling unit fan efficacy of <_ 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. All dwelling units shall meet the requirements of ASHRAE Standard 62.2. Neither window operation nor continuous operation of §150.0(o): central forced air system air handlers used in central fan integrated ventilation systems are permissible methods of providing the Whole Building Ventilation. § 150.0(o)IA: Whole Building Ventilation airflow shall be confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Pool and Spa Heating Systems and Equipment Measures: Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency § 110.4(a): Regulations; an on-off switch mounted outside of the heater that allows shutting off the heater without adjusting the thermostat setting; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating. 2013 Low -Rise Residential Mandatory Measures Summary § 110.4(b)1: Any pool or spa heating equipment shall be installed with at least 36 inches of pipe between filter and heater or dedicated suction and return lines, or built-up connections for future solar heating. § 110.4(b)2: Outdoor pools or spas that have a heat pump or gas heater shall have a cover. § 110.4(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or pro- grammed to run only during off-peak electric demand periods. § 110.5: Natural gas pool and spa heaters shall not have a continuous burning pilot light. § 150.0(p): Residential pool systems or equipment shall meet specified pump sizing, flow rate, piping, filters, and valve requirements. Lighting Measures: §110.9: All lighting control devices and systems, ballasts, and luminaires shalt meet the applicable requirements of §110.9. §150.0(k)IA: Installed luminaires shall be classified as high -efficacy or low -efficacy for compliance with §150.0(k) in accordance with TABLE 150.0-A or TABLE 150.0-B, as applicable. §150.0(k)1B: When a high efficacy and low efficacy lighting system are combined in a single luminaire, each system shall separately comply with the applicable provisions of § 150.0(k). The wattage and classification of permanently installed luminaires in residential kitchens shall be determined in accordance with § 150.0(k)1C: § I30.0(c). In residential kitchens, the wattage of electrical boxes finished with a blank cover or where no electrical equipment has been installed, and where the electrical box can be used for a luminaire or a surface mounted ceiling fan, shall be calculated as 180 watts of low efficacy lighting er electrical box. §150.0(k)ID: Ballasts for fluorescent lamps rated 13 watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. Permanently installed night lights and night lights integral to installed luminaires or exhaust fans shall be rated to consume no §150.0(k)IE: more than 5 watts of power per luminaire or exhaust fan as determined in accordance with § I30.0(c). Night lights do not need to be controlled by vacancy sensors. §150.0(k)1F: Lighting integral to exhaust fans (except when installed by the manufacturer in kitchen exhaust hoods) shall meet the applicable requirements of § 150.0(k). § I50.0(k)2A: High efficacy luminaires must be switched separately from low efficacy luminaires. § 150.0(k)2B: Exhaust fans shall be switched separately from lighting systems. § 150.0(k)2C: Luminaires shall be switched with readily accessible controls that permit the luminaires to be manually switched ON and OFF. § I50.0(k)2D: Controls and equipment are installed in accordance with manufacturer's instructions. § 150.0(k)2E: No control shall bypass a dimmer or vacancy sensor function if the control is installed to comply with § 150.0(k). § I50.0(k)2F: Lighting controls comply with applicable requirements of § 110.9. An Energy Management Control System (EMCS) may be used to comply with dimmer requirements if. it functions as a dimmer § 150.0(k)2G: according to § 110.9; meets Installation Certificate requirements of § 130.4; the EMCS requirements of § 130.5; and all other requirements in § 150.0 2. An Energy Management Control System (EMCS) may be used to comply with vacancy sensor requirements of §I50.0(k) if: it § 150.0(k)2H: functions as a vacancy sensor according to § 110.9; meets Installation Certificate requirements of § 130.4; the EMCS requirements of § 130.5; and all other requirements in § 150.0(k)2. § I50.0(k)2I: A multiscene programmable controller may be used to comply with dimmer requirements of this section if it provides the functionality of a dimmer according to § 110.9, and complies with all other applicable requirements in § 150.0(k)2. §150.0(k)3A: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. Kitchen lighting includes all permanently installed lighting in the kitchen except internal lighting in cabinets that illuminate only § 150.0(k)3B: the inside of the cabinets. Lighting in areas adjacent to the kitchen, including but not limited to dining and nook areas, are considered kitchen lighting if they are not separately switched from kitchen lighting. §150.0(k)4: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. §150.0(k)5: A minimum of one high efficacy luminaire shall be installed in each bathroom; and all other lighting installed in each bathroom shall be high efficacy or controlled by vacancy sensors. § 150.0(k)6: Lighting installed in attached and detached garages, laundry rooms, and utility rooms shall be high efficacy luminaires and controlled by vacancy sensors. § 150.0(k)7: Lighting installed in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, and utility rooms shall be high efficacy, or shall be controlled by either dimmers or vacancy sensors. Luminaires recessed into ceilings shall: be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; have a label that certifies that the luminaire is airtight with air leakage less than 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; be sealed with a gasket or caulk between the luminaire housing § I50.0(k)8: and ceiling, and shall have all air leak paths between conditioned and unconditioned spaces sealed with a gasket or caulk; and allow ballast maintenance and replacement without requiring cutting holes in the ceiling. For recessed compact fluorescent luminaries with ballasts to qualify as high efficacy for compliance with § I50.0(k), the ballasts shall be certified to the Energy Commission to comply with the applicable requirements in § 110.9. For single-family residential buildings, outdoor lighting permanently mounted to a residential building or other buildings on the same lot shall be high efficacy, or may be low efficacy if it meets all of the following requirements: i. Controlled by a manual ON and OFF switch that does not override to ON the automatic actions of Items ii or iii below; and § 150.0(k)9A: ii. Controlled by a motion sensor not having an override or bypass switch that disables the motion sensor, or controlled by a motion sensor having a temporary override switch which temporarily bypasses the motion sensing function and automatically reactivates the motion sensor within 6 hours; and iii. Controlled by one of the following methods: 2013 Low -Rise Residential Mandatory Measures Summary a. Photocontrol not having an override or bypass switch that disables the photocontrol; or b. Astronomical time clock not having an override or bypass switch that disables the astronomical time clock, and which is programmed to automatically turn the outdoor lighting OFF during daylight hours; or c. Energy management control system which meets all of the following requirements: At a minimum provides the functionality of an astronomical time clock in accordance with § 110.9; meets the Installation Certification requirements in § 130.4; meets the requirements for an EMCS in § 130.5; does not have an override or bypass switch that allows the luminaire to be always ON; and, is programmed to automatically turn the outdoor lighting OFF during daylight hours. For low-rise multifamily residential buildings, outdoor lighting for private patios, entrances, balconies, and porches; and outdoor lighting for residential parking lots and residential carports with less than eight vehicles per site shall comply with one of the § 150.0(k)9B: following requirements: i. Shall comply with § 150.0(k)9A; or ii. Shall comply with the applicable requirements in §110.9, §130.0, §130.2, § 130.4, §140.7 and §141.0. § 150.0(k)9C: For low-rise residential buildings with four or more dwelling units, outdoor lighting not regulated by § 150.0(k)9B or 150.0(k)9D shall comply with the applicable requirements in § 110.9, § 130.0, § 130.2, § 130.4, § 140.7 and § 141.0. § 150.0(k)9D: Outdoor lighting for residential parking lots and residential carports with a total of eight or more vehicles per site shall comply with the applicable requirements in § 110.9, § 130.0, § 130.2, § 130.4, § 140.7 and § 141.0. §150.0(k)10: Internally illuminated address signs shall comply with § 140.8; or shall consume no more than 5 watts of power as determined according to § 130.0(c). §150.0(k) 11: Lighting for residential parking garages for eight or more vehicles shall comply with the applicable requirements for nonresidential garages in § 110.9, § 130.0, § 130. 1, § 130.4, § 140.6, and § 141.0. In a low-rise multifamily residential building where the total interior common area in a single building equals 20 percent or less of § 150.0(k)12A: the floor area, permanently installed lighting for the interior common areas in that building shall be high efficacy luminaires or controlled by an occupant sensor. In a low-rise multifamily residential building where the total interior common area in a single building equals more than 20 percent of the floor area, permanently installed lighting in that building shall: §150.0(k)12B: i. Comply with the applicable requirements in §110.9, §130.0, §130.1, §140.6 and §141.0; and ii. Lighting installed in corridors and stairwells shall be controlled by occupant sensors that reduce the lighting power in each space by at least 50 percent. The occupant sensors shall be capable of turning the light fully On and Off from all designed paths of ingress and egress. Solar Ready Buildings: Single family residences located in subdivisions with ten or more single family residences and where the application for a § 110.10(a)l: tentative subdivision map for the residences has been deemed complete, by the enforcement agency, on or after January 1, 2014, shall comply with the requirements of § 110.1 0 b through 110.10(e). § 110.10(a)2: Low-rise multi -family buildings shall comply with the requirements of § 110.10(b) through § 110.10(d). The solar zone shall have a minimum total area as described below. The solar zone shall comply with access, pathway, smoke ventilation, and spacing requirements as specified in Title 24, Part 9 or other Parts of Title 24 or in any requirements adopted by a local jurisdiction. The solar zone total area shall be comprised of areas that have no dimension less than 5 feet and are no less than 80 square feet each for buildings with roof areas less than or equal to 10,000 square feet or no less than 160 square feet each for § 110.10(b)1: buildings with roof areas greater than 10,000 square feet. For single family residences the solar zone shall be located on the roof or overhang of the building and have a total area no less than 250 square feet. For low-rise multi -family buildings the solar zone shall be located on the roof or overhang of the building or on the roof or overhang of another structure located within 250 feet of the building or on covered parking installed with the building project and have a total area no less than 15 percent of the total roof area of the building excluding any skylight area. § 110.10(b)2: All sections of the solar zone located on steep -sloped roofs shall be oriented between 110 degrees and 270 degrees of true north. § 110.10(b)3A: No obstructions, including but not limited to, vents, chimneys, architectural features, and roof mounted equipment, shall be located in the solar zone. Any obstruction, located on the roof or any other part of the building that projects above a solar zone shall be located at least twice § 110.10(b)3B: the distance, measured in the horizontal plane, of the height difference between the highest point of the obstruction and the horizontal projection of the nearest point of the solar zone, measured in the vertical plane. § 110.10(b)4: For areas of the roof designated as solar zone, the structural design loads for roof dead load and roof live load shall be clearly indicated on the construction documents. The construction documents shall indicate: a location for inverters and metering equipment and a pathway for routing of conduit § 110.10(c): from the solar zone to the point of interconnection with the electrical service (for single family residences the point of interconnection will be the main service panel); a pathway for routing of plumbing from the solar zone to the water -heating system. §1 10.10(d): A copy of the construction documents or a comparable document indicating the information from § 110.10(b) through § 110.10(c) shall be providedto the occupant. §110.10(e)l: The main electrical service panel shall have a minimum busbar rating of 200 amps. The main electrical service panel shall have a reserved space to allow for the installation of a double pole circuit breaker for a § 110.10(e)2: future solar electric installation. The reserved space shall be: positioned at the opposite (load) end from the input feeder location or main circuit location, and permanently marked as "For Future Solar Electric'. ZONE LOAD SUMMARY Project Name John Drive Addition Date 4/30/2015 System Name HVAC System Floor Area 1,890 ZONE LOAD SUMMARY ZONAL SYSTEM COOLING PEAK HEATING PEAK ZONE NAME SYSTEM NAME Mult. CFM Sensible Latent Heating OA CFM Peak Hr CFM Sensible Latent CFM Sensible Existing 1st Floor 1.0 0 Aug 3 PM 800 16,415 650 684 25,967 1 st Floor Addition 1.0 0 Aug 3 PM 243 4,993 411 153 5,825 TOTALS1 0 0 0 0 Aug 3 PM 1 21,408 1,062 31,792 (BLOCK LOAD) EnergyPro 6.5 by EnergySoft User Number: 6249 RunCode: 2015-04-30T11:27:27 ID: 15-04307 Page 16 of 16 CUPERTINO STATEMENT OF SPECIAL INSPECTIONS, 2013 CBC COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org SITE ADDRESS �T �t� Ooh APN BP#/ U C` 7 Owner ...................... ... 1-71V .......K..V.......... . Y ..................... Contractor....................................................................................................... C- Zi' 1 S Address .........�...1.�.Z-10 AN ............................. Address........................................................................................................... Signature ........... City/St ............ CjUf?GST.N.e.zip ........ C:/'�-Dl51..i Pnone.0.9.6go.32 City/St................................................. Zip Phone ........................ Applicant......... ...... NNL........ W. .J.Q.6............. s................... Engineer/Architect .... ,� �':...4EZa................ .......................... Address ....... rQ.9 E.....��....(LT.......................................... Address.. .. �A.....A k... ..c -W.... r .. � .. r/rH D� City/St.............Y.................. zip ...... ly< (X .....Phone. .... .11 ��yyJJ�� r1 ity/St...s��itirt'Tl�� U6............Zi ��%.. Phone G.%....ISS P'W• R PROJECT DESCRIPTION Si nature..................................................................Li�#"..Z�e�.,? CC �..................... This "STATEMENT OF SPECIAL INSPECTIONS" is submitted in fulfillment of the requirements of CBC Sections 1704 and 1705. This form is structured after and used by permission from the Structural Engineer Association of Northern California's (SEAONC) mode statement of Special Inspections. Also, included with this form is the following: ❑ "LIST OF SPECIAL INSPECTION AGENCIES (page 2). A list of testing agencies and other special inspectors that will be retained to conduct the tests and inspections for this project ❑ "SCHEDULE OF SPECIAL INSPECTION" (page 3 — 6). The Schedule of Special Inspections summarizes the Special Inspections and tests required. Special Inspectors will refer to the approved plans and specifications for detailed special inspection requirements. Any additional tests and inspections required by the approved plans and specifications shall also be performed. Special Inspections and Testing will be performed in accordance with the approved plans and specifications, this statement and CBC Sections 1704, 1705, 1706, 1707, and 1708. Interim reports will be submitted to the Building Official and the Registered Design Professional in Responsible Charge in accordance with CBC Section 1704.1.2. A Final Report of Special Inspections documenting required Special Inspections, testing and correction of any ciiscrepan,pies noted in the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704.1.2). The Final Report will document: • Required special inspections. OFFICE • Correction of discrepancies noted in inspections. COPY The Owner recognizes his or her obligation to ensure that the construction complies with the approved permit documents and to implement this program of special inspections. In partial fulfillment of these obligations, the Owner will retain and directly pay for the Special Inspections as required in CBC Section 1704.1. This plan has been developed with the understanding that the Building Official will: • Review and approve the qualifications of the Special Inspectors who will perform the inspections. • Monitor special inspection activities on the job site to assure that the Special Inspectors are qualified and are performing their duties as called for in this Statement of Special Inspection. • Review submitted inspection reports. • Perform inspections as required by the local building code. l have read and agree to comply with the ter -fid conditions of this statement Prepared By: Project ❑ Engineer 9 Architect C- Zi' 1 S Registered Design Professional in Charge Signature ........... ........... ............................... ............Lic.# ..................... . �r ......... Date:..¢..Z..� Owner Name: Owner's Authorization Signature .................................... ............................................................................. Date:.......................... Inspection Agency/ Inspector Name: Si nature..................................................................Li�#"..Z�e�.,? CC �..................... Date: .F . ......... Building Official r designee: Si nature...., . .......................... ............... ,t Date: ..f31'f✓. SpecialnspectionForn= 2012.doc revised 09/06/12 2 LIST OF SPECIAL INSPECTION AGENCIES APPROVAL OF SPECIAL INSPECTORS: Each special inspection agency, testing facility, and special inspector shall be recognized by the Building Official prior to performing any duties. Special Inspection agency's listed on this form must be pre -approved and listed on Cupertino's approved Special Inspector's list. Special inspectors shall carry approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the California Council of Testing and Inspection Agencies. No personnel changes shall be made without first obtaining the approval of the Building Official. Any unauthorized personnel changes may result in a "Stop Work Order" and possible permit revocation. To be pre- approved by the City of Cupertino, refer to the SPECIAL INSPECTION CRITERIA handout. Please allow two weeks to complete the application process. The following are the testing and special inspection agencies that will be retained to conduct tests and inspection on this pro/ect EXPERTISE FIRM / INSPECTOR INFORMATION' 1. Special Inspection (except for Firm.....................................................................Addr......................................................................................... geotechnical) Cit ................................... State .......................Zi Telephone...................................... Fax ............................................ Email......................................................... 2. Material Testing Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone.......................................Fax............................................ Email .......... ................................................ 3. Geotechnical Inspections Firm.....................................................................Addr................................: City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................ Email......................................................... 4. Other: Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................ Email......................................................... `All agencies specified on this form must be pre -approved and listed on the City of Cupertino's Approved Special Inspector's List. SEISMIC REQUIREMENTS (Section 1705.3.6) Description of seismic -force -resisting system and designated seismic systems subject to special inspections as per Section 1705.3: The extent of the seismic -force -resisting system is defined in more detail in the construction documents. WIND REQUIREMENTS Section 1705.4.1 Description of main wind -force -resisting system and designated wind resisting components subject to special inspections in accordance with Section 1705.4.2: The extent of the main wind -force -resisting system and wind resisting components is defined in more detail in the construction documents. SpecialnspectionForm_2012.doc revised 09/06/12 SCHEDULE OF SPECIAL INSPECTION SITE APN BP# ADDRESS PROJECT DESCRIPTION: Notation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes and/or contract documents should clarify. Box entries: X Is placed in the appropriate column to denote either "C" continuous or "P" periodic inspections. --- Denotes an activity that is either a one-time activity or one whose frequency is defined in some other manner. Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VERIFICATION AND INSPECTION C p REFERENCED IBC REFERENCE STANDARD INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality control 1704.3 procedures. INSPECTION OF STEEL 1. Material verification of high-strength bolts, nuts and washers. ❑ Identification marking to conform to ASTM stds AISC 360, specified in the approved construction documents. --- X Section A3.3 and applicable ASTM material standards ❑ Inspect fabricator's fabrication and quality control procedures. X 2. Inspection of high-strength bolting: ❑ Snug -tight joints. --- X ❑ Pretensioned and slip -critical joints using turn -of -nut with matchmarking, twist -off bolt or direct tension --- X AISC 360, indicator methods of installation. 1704.3.3 Section M2.5 ❑ Pretensioned and slip -critical joints using turn -of -nut without matchmarking or calibrated wrench methods X --- of installation. 3. Material verification of structural steel and cold -formed steel deck. ❑ For structural steel, identification markings to conform X AISC 360, to AISC 360. Section M2.5 ❑ For other steel, identification markings to conform to Applicable ASTM ASTM standards specified in the approved --- X material standards construction documents. ❑ Manufacturer's certified test reports. --- X SpecialnspectionFonn 2012.doc revised 09/06/12 VERIFICATION AND INSPECTIONC p REFERENCEDIBC STANDARD REFERENCE 4. Material verification of weld filler materials: ❑ Identification marking to conform to AWS specification in the approved construction documents. --- X AISC 360, Section A3.5 and applicable AWS A5 documents 1704.3 ❑ Manufacturer's certificate of compliance required. --- X --- --- 5. Inspection of welding: a. Structural steel and cold -formed steel deck: ❑ Complete and partial joint penetration groove welds. X --- AWS D1.1 1704.3.1 ❑ Multipass fillet welds. X --- ❑ Single -pass fillet welds > 5/16" X --- ❑ Plug and slot welds. X --- ❑ Single -pass fillet welds <= 5/16" --- X ❑ Floor and roof deck welds. --- X AWS D1.3 b. Reinforcing steel: ❑ Verification of weldability of reinforcing steel other than ASTM A 706. X AWS D1.4 ACI 318: Section 3.5.2 ❑ Reinforcing steel resisting flexural and axial forces in intermediate and special moment frames, and boundary elements of special structural walls of concrete and shear reinforcement. X ___ ❑ Shear reinforcement. X --- ❑ Other reinforcing steel. --- X 6. Inspection of steel frame joints details for compliance: ❑ Details such as bracing and stiffening. --- X --- 1704.3.2 ❑ Member locations. --- X ❑ Application of joint details at each connection. --- X VERIFICATION AND INSPECTIONC p REFERENCED STANDARD IBC REFERENCE INSPECTION OF WELDING 1. ❑ Welded studs when used for structural diaphragms. --- X --- 1704.3 2. ❑ Welding of cold -formed steel framing members. --- X 3. ❑ Welding of stairs and railing systems. --- X SpecialnspectionForm_2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C _F__ p REFERENCED IBC STANDARD REFERENCE INSPECTION OF CONCRETE 1. ❑ Inspection of reinforcing steel, including prestressing --- X ACI 318: 3.5, 7.1-7.7 1913.4 tendons and placement. 2. ❑ Inspection of reinforcing steel welding in accordance AWS D1.4 ACI 318: with Table 1704.3 Item 5b. 3.5.2 3. ❑ Inspection of bolts to be installed in concrete prior to and during placement of concrete where allowable X ACI 318: 8.1.3, 1911.5, 1912.1 loads have been increased or where strength design 21.2.8 is used. 4. ❑ Inspection of anchors installed in hardened concrete. --- X ACI 318: 1912.1 5. ❑ Verifying use of required design mix. 1904.2.2,1913.2, --- X ACI 318: 1913.3 6. ❑ At time fresh concrete is sampled to fabricate ASTM C 172 specimens for strength tests, perform slump and air X --- ASTM C 31 1913.10 content tests and determine the temperature of the concrete. ACI 318: 5.6, 5.8 7. ❑ Inspection of concrete and shotcrete placement for X --- ACI 318: 5.9, 5.10 1913.6, 1913.7, proper application techniques. 1913.8 8. ❑ Inspection for maintenance of specified curing --- X ACI 318: 5.11-5.13 1913.9 temperature and techniques. 9. Inspection of prestressed concrete: ❑ Application of prestressing forces. X --- ACI 318:18.20 ❑ Grouting of bonded prestressing tendons in the X --- ACI 318: 18.18.4 seismic force -resisting system. 10. ❑ Erection of precast concrete members. --- X ACI 318: Ch. 16 --- 11. ❑ Verification of in-situ concrete strength, prior to stressing of tendons in posttensioned concrete and --- X ACI 318: 6.2 --- prior to removal of shores and forms from beams and structural slabs. 12. ❑ Inspect formwork for shape, location, and dimensions --- X ACI 318: 6.6.1 --- of the concrete member being formed. 13. Bolts Installed in Existing Masonry or Concrete ❑ Direct tension testing of existing anchors. --- X See ICC ES Reports form special inspection requirements for proprietary ❑ Direct tension testing of new bolts. --- X ❑ Torque testing of new bolts. --- X products ❑ Prequalification test for bolts and other types of anchors. --- X 14. ❑ Other: SpecialnspectionForm_2012.doc revised 09/06/12 SpecialnspectionForm_2012.doc revised 09106112 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION I 530/ASCE 5 530/ASCE 6 INSPECTION OF LEVEL 1 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals shall be verified. 2. ❑ Verification of f'm and f AAc prior to construction X --- --- Art. 1.413 except where specifically exempted by this code. 3. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.513.1.b.3 the site for self consolidating grout. 4. As masonry construction begins, the following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar. --- X --- --- Art. 2.6A ❑ Construction of mortar joints. --- X --- --- Art.3.313 ❑ Location of reinforcement, connectors, X --- --- Art. 3.4, 3.6A prestressing tendons, and anchorages. ❑ Prestressing technique. --- X --- --- Art. 3.613 ❑ Grade and size of prestressing tendons and --- X --- --- Art. 2.413, 2.4H anchorages. 5. During construction the inspection program shall verify: ❑ Size and location of structural elements. --- X --- --- Art. 3.3F ❑ Type, size, and location of anchors, including Sec. 1.2.2(e), other details of anchorage of masonry to --- X ___ 1.16.1 --- structural members, frames or other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- --- --- ❑ Preparation, construction and protection of masonry during cold weather (temperature below ___ X Sec. 2104.3, --- Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.613 force. 6. Prior to grouting the following shall be verified to ensure compliance: ❑ Grout space is clean. --- X --- --- Art. 3.2D ❑ Placement of reinforcement and connectors and --- X --- Sec. 1.3 Art. 3.4 prestressing tendons and anchorages. ❑ Proportions of site -prepared grout and X --- --- Art. 2.66 prestressing grout for bonded tendons. ❑ Construction of mortar joints. --- X --- --- Art. 3.36 7. Grout placement: ❑ Grout placement shall be verified ensure X --- --- --- Art. 3.5 compliance. ❑ Observe grouting of prestressing bonded X --- --- --- Art 3.6C tendons. SpecialnspectionForm_2012.doc revised 09106112 SpecialnspectionForm_2012.doc revised 09106/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION 530/ASCE 5 530/ASCE 6 8. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be --- X 2105.2.2, --- Art. 1.4 observed. 2105.3 INSPECTION OF LEVEL 2 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals. 2. ❑ Verification of fm and franc prior to construction and for every 5,000 square feet during --- X --- --- Art. 1.4B construction. 3. ❑ Verification of proportions of materials in premixed or preblended mortar and grout as --- X --- --- Art. 1.5B delivered to the site. 4. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.5B.1.b.3 the site for self consolidating rout. 5. The following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar, grout, and --- X --- --- Art. 2.6A prestressing grout for bonded tendons. ❑ Placement of masonry units and construction of --- X --- --- Art. 3.313 mortar joints. ❑ Placement of reinforcement, connectors and --- X --- Sec. 1.15 Art. 3.4, 3.6A prestressing tendons and anchorages. ❑ Grout space prior to grouting. X --- --- --- Art. 3.2D ❑ Placement of grout. X --- --- --- Art. 3.5 ❑ Placement of prestressing grout. X --- --- --- Art. 3.6C ❑ Size and location of structural elements. --- X --- --- Art. 3.31F ❑ Type, size, and location of anchors, including other details of anchorage of masonry to X --- --- Sec.1.2.2(e) structural members, frames and other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- - - Sec. 2.1.9.7.2, --- 3.3.3.4 (b) ❑ Preparation, construction, and protection of masonry during cold weather (temperature below X Sec. 2104.3, --- Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.613 force. 6. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be X --- 2105.2.2, --- Art. 1.4 observed. 2105.3 SpecialnspectionForm_2012.doc revised 09106/12 VERIFICATION AND INSPECTION C p REFERENCED IBC STANDARD REFERENCE INSPECTION OF WOOD 1. ❑ Inspect prefabricated wood structural elements and assemblies in accordance with Section 1704.2. --- 1704.6 2. ❑ Inspect site built assemblies. --- --- 3. Inspect high -load diaphragms: ❑ Verify grade and thickness of sheathing. --- --- ❑ Verify nominal size of framing members at adjoining panel edges. --- 1704.6.1 ❑ Verify nail or staple diameter and length, --- --- ❑ Verify number of fastener lines, --- 0 Verify spacing between fasteners in each line and at edge margins. 4. ❑ Metal -plate -connected wood trusses spanning 60 feet or greater: Verify temporary installation restraint/bracing and the permanent individual truss --- X --- 1704.6.2 member bracing are installed in accordance with the approved truss submittal package. REQUIRED VERIFICATION AND INSPECTION OF SOIL 1. ❑ Verify materials below footings are adequate to achieve the desired bearing capacity. --- X 2. ❑ Verify excavations are extended to proper depth and X have reached proper material. 3. ❑ Perform classification and testing of compacted fill materials. X --- Table 1704.7 4. ❑ Verify use of proper materials, densities and lift thicknesses during placement and compaction of X --- compacted fill. 5. ❑ Prior to placement of compacted fill, observe subgrade and verify that site has been prepared properly. --- X REQUIRED VERIFICATION AND INSPECTION OF DEEP DRIVEN FOUNDATION ELEMENTS 1. ❑ Verify element materials, sizes and lengths comply X --- with the requirements. 2. ❑ Determine capacities of test elements and conduct X additional load tests, as required. 3. ❑ Observe driving operations and maintain complete X - and accurate records for each element. 4. ❑ Verify locations of piles and their plumbness, confirm type and size of hammer, record number of blows per --- Table 1704.8 foot of penetration, determine required penetrations to X --- achieve design capacity, record tip and butt elevations and document any damage to foundation element. 5. ❑ For steel elements, perform additional inspections in accordance with Section 1704.3. 6. ❑ For concrete elements and concrete filled elements, perform additional inspections in accordance with --- --- Section 1704.4. SpecialnspectionFonn 2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE 7. ❑ For specialty piles, perform additional inspections as determined by the registered design professional in --- --- --- Table 1704.8 responsible charge. REQUIRED VERIFICATION AND INSPECTION OF CAST -IN-PLACE DEEP FOUNDATION ELEMENTS 1 ❑ Observe drilling operations and maintain complete and X -- accurate records for each element. 2. ❑ Verify placement locations and plumbness, confirm element diameters, bell diameters (if applicable), lengths, embedment into bedrock (if applicable), and X --- --- Table 1704.9 adequate end -bearing strata capacity. Record concrete or grout volumes. 3. ❑ For concrete elements, perform additional inspections in accordance with Section 1704.4. HELICAL PILE FOUNDATIONS 1. ❑ Record installation equipment used, pile dimensions, X --- --- 1704.10 tip elevations, final depth, final installation torque. SPRAYED FIRE-RESISTANT MATERIALS Physical and visual tests 1. Condition of substrates. ❑ Inspect surface for accordance with the approved fire - resistance design and the approved manufacturer's --- --- written instructions. ❑ Verify minimum ambient temperature before and after X application. - 1704.12.1 ❑ Verify ventilation of area during and after application. --- X 2. ❑ Measure average thickness per ASTM E605 and Section 1704.12.4. --- --- --- 3. ❑ Verify density of material for conformance with the approved fire-resistant design and ASTM E605. (Ref. --- --- Section 1704.12.5) 4. ❑ Test cohesive/adhesive bond strength per Section 1704.12.6. 5. ❑ Condition of finished application. MISCELLANEOUS 1. Mastic and Intumescent Fire -Resistant Coating. --- --- --- 1704.13 2. Exterior Insulation and Finish Systems (EIFS). Water - resistive barrier coating when installed over a sheathing --- --- --- 1704.14 substrate. 3. Special Cases --- --- --- 1704.15 4. Smoke Control System --- --- --- 1704.16 5. Seismic Resistance ❑ Suspended ceiling systems and their anchorage. --- --- --- 1705.3 [4.3] SpecialnspectionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTIONC p REFERENCED IBC STANDARD REFERENCE 6. Wind Resistance ❑ Roof cladding and roof framing connections. --- --- --- ❑ Wall connections to roof and floor diaphragms and framing. ❑ Roof and floor diaphragm systems, including collectors, drag struts and boundary elements. ❑ Vertical wind -force -resisting systems, including braced frames, moment frames, and shear walls. ❑ Wind -force -resisting system connections to the foundation. ❑ Fabrication and installation of systems or components required to meet the impact resistance requirements --- --- --- of Section 1609.1.2. SPECIAL INSPECTION FOR WIND REQUIREMENTS 1. Structural Wood ❑ Inspect field gluing operations of elements of the main X wind -force -resisting system. --- 1706.2 ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the main windforce-resisting X system, including wood shear walls, wood diaphragms, drag struts, braces and hold-downs. 2. Cold -Formed Steel Framing ❑ Welding of elements of the main wind -force -resisting X system. - ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the main --- 1706.3 wind -force -resisting system including shear walls, --- X braces, diaphragms, collectors (drag struts) and hold- downs. 3. Wind -resisting components ❑ Roof cladding. --- X --- 1706.4 ❑ Wall cladding. --- X SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE 1. ❑ Special inspection for welding in accordance with the X --- 1707.2 quality assurance plan requirements of AISC 341. 2. Structural Wood ❑ Inspect field gluing operations of elements of the X seismic -force -resisting system. ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the seismic -force -resisting 1707.3 system, including wood shear walls, wood --- X diaphragms, drag struts, braces, shear panels and hold-downs. 3. Cold -Formed steel light -frame construction ❑ Welding of elements of the seismic -force -resisting X 1707.4 system. SpecialnspectionForm_2012.doc revised 09/06/12 ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the seismic- X force -resisting system including shear walls, braces, diaphragms, collectors (drag struts) and hold-downs. 4. Storage racks and access floors ❑ Anchorage of storage racks 8 feet or greater in height X 1707.5 and access floors. 5. Architectural components ❑ Inspect erection and fastening of exterior cladding weighing more than 5 psf and higher than 30 feet --- X above grade or walking surface. ❑ Inspect erection and fastening of veneer weighing more than 5 psf.and higher than 30 feet above grade --- X or walking surface. --- 1707.6 ❑ Inspect erection and fastening of all exterior non- bearing walls higher than 30 feet above grade or --- X walking surface. ❑ Inspect erection and fastening of all interior non- bearing walls weighing more than 15 psf and higher --- X than 30 feet above grade or walking surface. 6. Mechanical and Electrical Components ❑ Inspect anchorage of electrical equipment for X emergency or stand-by power systems. ❑ Inspect anchorage of non -emergency electrical X equipment. ❑ Inspect installation of piping systems and associated mechanical units carrying flammable, combustible, or --- X --- 1707.7 highly toxic contents. ❑ Inspect installation of HVAC ductwork that contains X hazardous materials. ❑ Inspect installation of vibration isolation systems X where required by Section 1707.7. 7. ❑ Verify that the equipment label and anchorage or mounting conforms to the certificate of compliance 1707.8 when mechanical and electrical equipment must be seismically qualified. 8. ❑ Seismic isolation system: Inspection of isolation --- X --- 1707.9 system per ASCE 7 — Section 17.2.4.8 9. ❑ Obtain mill certificates for reinforcing steel, verify compliance with approved construction documents, --- --- --- 1708.2 and verify steel supplied corresponds to certificate. 10. ❑ Structural Steel: Invoke the QAP Quality Assurance requirements in AISC 341. -_- 1708.3 11. ❑ Obtain certificate that equipment has been seismically 1708.4 qualified. ___ 12. ❑ Obtain system tests as required by ASCE 7 Section 17.8. --- --- 1708.5 SpecialnspectionFam_2012.doc revised 09/06/12 F . CALGREEN RESIDENTIAL CHECKLIST — MARgfTTQV ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION; CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 By (408) 777-3228 • FAX (408) 777-3333 • buildinq(a,cupertino.ong PURPOSE: The 2013 CalGreen Code applies to additions or alterations of existing residential buildings where the Aition or alteration increases the building's conditioned area, volume, or size and also applies to all new low-rise residential buildings, high-rise residential buildings, or both. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: i- k/fI2tf i Uslbt-iyFE . Project Address: p] (y J a 1+N ;gr iV E j' A) riw&V Project Description: jt F - /1-019 al 0!V Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 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 ownec_a_acL the design,g- II initial Column 2 of this checklist, sign and date Section 1 - Design! yrl ': , ion at the orf' mst and have the j: %� Butidi checklist printed on the approved plans for the projec'E" , , ng Departrttent 3. Prior to final inspection by the Building Department, 1C�et• d professional shall complete Column 3 and sign and date Section 2 - Implementation Verip it the end of this checklist and submit the completed form to the Building Inspector. REVIEWED Ir -OR DUDE COMPLIANCE Reviewed By: .v h% low Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Requirements Planning and Design - Site Development 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during © ❑ construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage system will manage all surface water flows. Page I of 5 SUBMIT ra� OFFICE COPY #1 CalGreen_2014.doc revised 11/04/14 A4.2 General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum El design required by the California Energy Standards. A4.3 WATER EFFICIENCY ANDCONSERVATION Indoor Water Use 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following: ❑ 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank -type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank -type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen_2014.doc revised 11/04/14 Outdoor Water Use 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather -based. ❑ 4.304.1.1 Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ ❑ 4.304.1.2 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 communicated with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. .. .4 MATERIAL CONSERVATION AND RESOURCE EFFICIENCY Enhanced Durability and Reduced Maintenance 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected 125 against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. Construction Waste Reduction, Disposal and Recycling 4.408.2 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a ry construction waste management plan shall be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building occupant or owner. A4.5 Fireplaces 4.503.1 General. Install only a direct -vent sealed -combustion gas or sealed ❑ wood -burning fireplace, or a sealed woodstove. Pollutant Control 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air ❑ distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic compounds. Page 3 of 5 CalGreen_1014.doc revised 11104114 4.504.2.4 Verification. Documentation shall be provided to verify that ❑ compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with ❑ VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHPS) Low -emitting ❑ Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall ❑ comply with low formaldehyde emission standards. Interior Moisture Control 4.505.2 Concrete slab foundation. Required vapor retarders and capillary r CJ ❑ breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building ❑ materials used in wall and floor framing is checked before enclosure. Indoor Air Quality and Exhaust 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the ry YJ ❑ building are provided in every bathroom. Environmental Comfort 4.507.2. Duct systems are sized and designed and equipment is selected using the following methods: 1. Establish heat loss and heat gain values according to ACCA Manual J or equivalent. ❑ 2. Size duct systems according to ACCA 29-D (Manual D) or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S (Manual S) or equivalent. INSTALLER AND SPECIAL INSPECTOR QUALIFICATIONS Qualifications 702.1 Installer training. HVAC system installers are trained and certified in ❑ the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the ❑ discipline they inspect and verify. Verifications 703.1 Documentation. Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection reports, or other methods acceptable to the enforcing n/ 1�J ❑ agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 ColGreen_2014.doe revised 11104114 CALGREEN SIGNATURE DECLARATIONS Project Name: Project Address: Project Description: �Q �� Q �T. �l%r%jT/Or✓ SECTION 1 - 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 adopted by the City of Cupertino. 1 11 Owner's Signature Date V t -4-'-/tT-� r L t\J Owner's Name (Please Print) 1 D i of io s Signature Date W EI/ 1gG-[L 01 D-6 Design Profess' Name (Please Print) C� Signature of License Professional responsible for CalGreen compliance &ate Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email ddress for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION 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 Page 5 of 5 CalGreen_2014.doc revised 11/04/14 SC Design Group. 20370 Town Center Ln. Cupertino CA. 95014 Project: 6756 John Dr. Cupertino, CA Per the site installation of the epoxy holdowns, I can state that the contractor used SET -XP epoxy and has set the holdowns to stated required depth per project structural drawings. For any questions regardi a list d items above feel free to contact me. Zuishuang Che Susan Chen. DATE: