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15070132CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22372 MCCLELLAN RD CONTRACTOR: SFBA CONSTRUCTION PERMIT NO: 15070132 INC OWNER'S NAME: NG CHUN H ET AL 35640 FREMONT BLVD STE 136 DATE ISSUED: 12/07/2015 OWNER'S PHONE: 4082252533 FREMONT, CA 94536 PHONE NO: (650) 867-9606 13 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License f 0 DUPLEX - ADD 219 S.F. PER UNIT (438 S.F. TOTAL) TO Class Lie. # 7 s CREATE (N) MASTER SUITES IN EACH. REMODEL (E) X71 /f��7->Jlllr Contractor aC0 4 ODate 1,053 S.F. PER UNIT (2,106 S.F. TOTAL).RE-ROOF I hereby affirm that I am licensed under the provisions of Chapter 9 (Commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $400000 performance of the work for which this permit is issued. 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. APN Number: 35604027.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter , WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 D S FROM LAST CA ED INSPE T N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, C ° costs, and expenses which may accrue against said City in consequence of the157, granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section _ - 9.,18. �—RE-ROOFS: ��� Signature' Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. " ri OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of . the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio s 25505, 25533, and 25534. I _12/ 71 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec.. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally„ the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ® BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 o buildinaQcuDertino org v G ❑ NEW CONSTRUCTION ADDITION ALTERATION / TI � ❑ REVISION/ DEFERRED ORIGINAL PERNflT # APN # T AME PHO rSTREET E-MAIL v 4 DDRESS ' 2 F CITY, STATE, ZIP FAX I ':J tglsL PO d i CONTACT NAME PHONE b E-MAIL 6 —° G CJ`t�a STREET ADDRESS CITY, STATE, ZIP �dil� FAX f LISW ❑ OWNER ❑. OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # [CO7NTRACTOR ME E-MAIL FAX TESS CITY, STATE, ZIP PHONE RCHITE NGINEER [STREET LICENSE NUMBER j l BUS. LIC # OMPANY NAME % E-MAIL FAX ADDRESS CITY, STATE, ZIP �jC31 PHONE 2d J 6�i> DESCRIPTION OF WORK J EXISTING USE PROPOSED USE - - CONST R. T E - # STORIES - - - - - —Vfft'��;rDEMO R USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREAA CA AREA TOTAL NETAREA.;7 j i'- - - BATHROOM - KITCHEN -. . - OTHER REMODELAREAREMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH - - - fikATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES T SECOND STORY []YES - - BEING ADDED? ,G r ADDITION? -ZO PRE-APPLIC TION IF YES, PROVIDE COPY OF PLANNING APPL # NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? l No E $ TOTAL VALUATION' ; p By my signature below, I certify to each of the following: I am the property owner or au oriz o act e property owner's behalf. I ave read this application and the information I have provided is correct. I have read the Description of Work and veri . accurate. I agree to comply with all applicable local ordinances and state laws relating to building truction. I authorize representatives of Cupertino to ter the above -id ntified property for inspection purposes. Signature of Applicant/Agent: Date:L- SUPPLEMENT INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP Fl. ovER-VER-COUNTER ❑ BUILDING PLANREVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. Q EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANDAIW ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. 171 LARGE ' . 13 nn DEPT — Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJox [) SANITARIEWExDISTRIGT ❑ ENVIRONMENTAL REA .TH BldgApp 201 Ldoe revised 06/21111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 22372 MCCLELLAN RD DATE: 07/20/2015 REVIEWED BY: MELISSA AN: 356 04 027 BP#: *VALUATION: $400,000 *PERMIT TYPE: Building, Permit PLAN CHECK TYPE: Addition USE: SFD or Duplex 2nd Unit? 0 Yes No PENTAMATION OTC? 0 Yes ONO 'PERMIT TYPE: 1 R3SFDADD WORK DUPLEX - ADD 219 S.F. PER UNIT 438 S.F. TOTAL TO CREATE N MASTER SUITES IN EACH. , SCOPE I REMODEL (E) 1,053 S.F. PER UNIT (2,106 S.F. TOTAL). RE -ROOF (E) 30 SQ TO MATCH OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (S.L) PC FEES PC FEE ID BP FEES $1,626.00 BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 438 $1,626.00 IADDPLCK $1,323.00 IADDINSP' $0.00 3,000 s.f. $510.00 Re -roof IRERooFRES Permit Fee: $1,323.00 Suppl. Insp. Fee: Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (..{i}istri.lction T(r":. TOTALS: 438 6.00 fl,, ` $1,323.00 1YIEC11, IIURLY Yes, .No PLiMB,.©VRY Yes Afech Plan £. he ck. Pt vvb. Mari Chef.,X l h?c. Phm C tl�cl $1,626.00 EK s.f $5,456.00 wdf Fee: of"'?er Insp. CJtirer 'hUnafr Ins r�_ Other Elew. Ins,-;. «cfa r .4p. Fee"7'Iao,zb. l , .I Fete: e: Liec-. Imp" Fee: •�— — GA iovc cac:euueiees aue to otner ueparrments (t. e. Planning, Pubttc Works, hire, .Sanitary Sewer District, School DiwPirt_ otr_) Thoca fa.. - Ano 4 iLa FEE ITEMS (Fee Resolution 11-053 Eff. 7./1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,626.00 EK s.f $5,456.00 Remodel, Other 1REMRES2 Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 3,000 s.f. $510.00 Re -roof IRERooFRES Permit Fee: $1,323.00 Suppl. Insp. Fee: Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (..{i}istri.lction T(r":. Adinii-iiCtrative? Fee: 0 E Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: IPLLONGR $61.32 Select a Non -Residential Building or Structure 0 il'ifl'£l i)oel.11T'zenlaliori Fees: Strong Motion Fee: IBSEISMICR $52.00 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $16.00 UBTCITAVS: $3,07$.32 $5,966.000'AL T: E $9,044.32 Revised: 07/0212015 CUPERTINO PURPOSE: CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS 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(d),,cur)ertino_org The 2013 CalGreen Code applies to additions or alterations of existing residential buildings where the addition 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 requireme s �E COPY Project Name: Mr. � Mr -5. Ghon H. Ng Project Address: _22372 - 22374 McGlellan Rd- 95014 Project Description: Existincj Duplex ReSidentiol Addition $ Remodel (APN: 356-04-027) City Appl i roti on # 15070132 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 describtxd herein is properly planned and implemented in the project. -" 2. The licensed professional, in collaboration with the owner and the design'professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Reauirements 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. 1"v_!C I of'; CalGreen 2014.docrevised 11/04/14 Page 2 of 5 CalGreen 2014.doc revised 11/04/14 A4.2 General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum ❑ standard design required by the California Energy Standards. .. .3 WATER EFFICIENCY AND CONSERVATION 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. A4.4 MATERIAL 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 ❑ 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 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. .. .5 ENVIRONMENTAL QUALITY 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 RzJ 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 > CalGreen 2014.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 ® El 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 ❑ ❑ 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 ® ❑ 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 ^ LXJ ❑ 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 CalGreen 2014.doc revised 11/04/14 CALGREEN SIGNATURE DECLARATIONS .. Project Name: Mr. �f, Mrs. Chun H. Project Address: 22372 - 22374 McClellan Rd., 95014 Project Description: Exi5tinq Duplex ReSidentiol Addition e, Remodel (APN: 356-04-027) 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. &l! ( "[ �/ El"," -\, �, . Zlo e Owner's Signature Date Chun H. Ng Owner's Name (Please Print) U/3"VL/D. [i Sept. 14, 2015 Design Professional's Signature Date David D. Warren 408 225-2533 Design Professional's Name (Please Print) (design professional who prepared drawings noted above) Signature of License Professional responsible for CalGreen compliance 6,p , r6 Date � Nameense Professional responsible for CalGreen compliance (Please Print) Phone of ic C) tl 54 Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION (to be completed by the General Contractor) 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 (General Contractor to submit to Building Dept. for building permit along with payment for outstanding permit fee. City Application # 95070132) I'agc > of ; CalGreen 2014.doc revised 11/04/14