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14120110CITY OF CUPERTINO BUILDING PERMIT I ILDING ADDRESS: 22340 REGNART RD CONTRACTOR: FOUR SEASONS HOME & PERMIT NO: 14120110 SOLAR OWNER'S NAME: SHEU, JESSICA HONWEI & OWNER'S PHONE: 4082552313 LICENSED CONTRACTOR'S DECLARATION License Class Lie. # Contractor 4{{t mate 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 performance of the work for which this permit is issued. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue a i stsaid City in consequence of the granting of this perm' itionaliy, licam understands and will comply with all non -point sour ul ons pe perti unicipal Code, ction 9.18. Signature Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 9. 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 (See.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2. 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. 3. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 114938 CAMDEN AVE #117 1 DATE ISSUED: 04/22/2015 SAN JOSE, CA 95124 1 PHONE NO: (488) 600-8570 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL INSTALL PREFAB SUNROOM ON (E) SECOND STORY DECK (196 SQ FT); ENCLOSE EXISTING SECOND STORY PATIO(63 SQFT) REVISION #1 REVISE SCOPE OF WORK TO ONLY INCLUDE SMALL ENCLOSURE AT (E) KITCHEN DECK (58 S.F.) — issued 10/15/2015 Sq. Ft Floor Area: I Valuation: $82000 APN Number: 36640007.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECT ON. Issued byyAQC01 %LLADate: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safes Code, Sections qW5,25533, and 25534. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 14300 TORRE AVENUE . CUPERTINO, CA 95014-3255 COPE T ANO (408) 777-3228 • FAX (4108) 777-3333 (a? buiidingeupertino.occi Q \Eta -CONSTRUCTION C1 ADDifiON E ALTERATION I TI u REVISION/ DEFERRED ORIGINAL PERNIIT # PROJECT Alss �i14RY+AAI� �.. Peotp STREFET t1Dl CITY, T.XIE,ZIP' �w� 2 o f%i/P r � � ,e FAX IJOWNER ❑ OWNER•BUILDER CI OW\ERAGEN'T t=7 ",nit4croR ®Cb\'rRAc-r aAGr&rr 0 ARCUrrFrT II sir. -Xr r--- r1 rc yr 4p�R.3CrtdR..`+;iAIE. DESCRIPTION' OF AYORK Y'I :5 /e'1 ,mss /.-)%r�� EXISTING USE LICENSE NUNIBER LICENSETYPE BUS. LTC Y C AVY\r117' /P �i E-bFAiL FAX S7REETADDRES.' CII';,ST-TI .;ZiP p SG�1� PHOhc ARCHITECTIENGIN•L•ER NA3tE LICENSE NUMBER SUS. LIC COMPAXY NAME E -AML F.A.\ STREET ADDRESS CITY, STATE. ZIP PHONE DESCRIPTION' OF AYORK Y'I :5 /e'1 ,mss /.-)%r�� EXISTING USE PROPOSED USE CO\STR. TYPE > STORIES USE TYPE OCC. SQ.FI'. VALUATION(S) EXISTG NEW FLOOR DL1t0 TOTAL. - - ARFA AREA AREA NET AREA RATnROOM KITCHEN OTHER - - . REkrpDELAREA REMODEL AREA REMODEL AREA PORCH AREA DLCKARVA TOTAL DECiGFOP.CHAREA GARAGEAREA: DETACH ( ATTACH 4DWELLLtiG, S.- ISASECO�iI)ti\fi'm (�`.T:S SECO.\AS'rORY -- AYES BEING ADDED? n\ O ADDITION? \O [ PRE•APPLICATIOY [lYES IF YES.PROVIDECOPYOF ISTIIE.BLDGXN (]YES 7777 77, ": - - TdT'tALVAL .a1TId\: PLA\\t\GAPPLr QttiO PLAA'NWGAPPROVAL LETTER EtCHLERIIDNIV. E] \0 t+ -"-t'+4 By my signature below, I certify to each of the following: I am tete property owner or authorised agent to act on the property owners oehatt. I nave react IBIS application and the infennation I have provided " ci.3E5! on of Wort: and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to building coones of Cupertino to enter the above-identifiedf� property for inspection purposes. S%natureof: ppY,cant gcn�= .�' AD //S SUPPLEMENTAL INFORNLATION REQUIRED u t Nen, 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. r as _ _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure l ! STAND ID farm if any Hazardous Materials are being used as part of this project. 0 LARGE _ Copy of Planning Approval Letter or fleeting with Planning prior to submittal of Building Permit application.Lilt BuIL"o"GF :-nEtlEtii' > t t Nm ,L -;G 7Lt k --i ATEA i kin DF -n S,3 $t A^ai' SFAA rFi Dl" CT `�' E'v:-IAO:ro'AtE`6T:AI tls,n STI BldgA.pp 201 Ldoc revised 06/2 1 /11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22340 REGNART RD OWNER'S NAME: SHEU, JESSICA HONWEI & OWNER'S PHONE: 4082552313 / LICENSED CONTRACTOR'S DECLARATION License Class- Lic. # 113 les. ContractorraJX ,lV&S6WS flMlr Date -- 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 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. APPLICANT CERTIFICATION 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 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-pC� {�ations per the Cupertino Municipal Code, Section 9.18. ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption; I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 CONTRACTOR: FOUR SEASONS HOME &) PERMIT NO: 14120110 SOLAR 1029 BLOSSOM HILL RD STE 4 DATE ISSUED: 04/22/2015 SAN JOSE, CA 95123 PHONE NO: (488) 600-8570 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL INSTALL PREFAB SUNROOM ON (E) SECOND STORY DECK (196 SQ FT); ENCLOSE EXISTING SECOND STORY PATIO (63 SQ FT). Sq. Ft Floor Area: t Valuation: $82000 ' APN Number: 36640007.00 1 Occupancy Type: I PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS TED INSPECTION. Date:/Z RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Se ' ns 3 a 4. Owner or authorized ag t: Date: q 2�`' f CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CUPEEtTINO CONSTRUCTION PERMIT APPLICATION' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildincf(ftupertino.orq Q. NEW CONSTRUCTION 1 1 Anr)rrTiiN F-1 A T -=T) A TTl1 T! — 1 1 r - ------�--- u •+�++J+�+-++iviT / 11 _ �_�. ttGY1J1V1V 11JJcr=C=L. UK1l11NAL FERMIr PROJECT ADDRESS p APN OWNERNAME I( Q (� C{ p PHO i% 8 2 J Z t E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONT CT NAME ( / "OV HO E-MAIL B - DY313 43 - STREET ADDRESS CITY, STATE; ZIP FAX OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR IMONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBE�^7t LICENSETYPE BUS. LIC # COMPANY NAMEE-MAIL 6$_P^ � r� r� s 5�K s. �c•�-� STREET ADDRESS ZCITY, STATE, ZIP PHONE -SA C yo 313 z ARCHITECT/ENGINEFR NAME LICENSE NUMBER BUS. LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP ( PHONE DESCRIPTION OF WORK hA. - EXISTING SE PROPOSED USE - CONSTR TYPE # STORIES_ -- -- a✓�wv /gC7y�.,. USE TYPE OCC. SQ.FT. VALUATION ($) ER NEW FDEMO LOOR AREA TOTALLOOR NETAREA- f .tw :�i�►- Z `6 2 BATHROOM KITCHEN OTHER - REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH - ❑ AT TACH I # DWELLING UNITS: IS A SECOND UNrr ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE -APPLICATION EI TBS IF YES, PROVIDE COPY OF IS THE BLDG AN❑. YES ME -VE -k -=r' .TOTAL VALUATION• PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER °{<-.. EICHLERHOME? ❑ 000 By my signature below, I certify to each of the following: I am the property owner or authorized age s� t on the rtY owner's behalf. I ha ad this application and the information I have provided is correct. I have read theDescription of Work and verify it urate. I agree to comply with all applicable local ordinances and state lays relating to building con on. authorize entatives of no to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: /) !� SUPPLEMENTAL INFO IO D - -=',-�.-PLANaCHECKK 'YPE,�_ _ „- _ROi3T.IivG MR THE-COIii\'TER � New SFD or Multifamily dwellings: A for demolition permit for existing building(s). Demolition permit required prior to issuance of building OYER = �"BUII.D,iNGP1;ANJ2EVIEi3T h r permit for new building imRPRE S ;*"" 70-- PI:ANNII3G LA?QREEw s _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD' 0LTcwxxS form if any Hazardous Materials are being used as part of this project. FII R Y Copy of Planning Approval Letter or Meeting with Planning prior to873 LARGE QR ', Q submittal of Building Permit application. wY�RD�IS�xrc } BldgApp 2011.doc revised 0 612 1/11 CUPERTINO NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 building(a-cupertino.org ADDITION ❑ ALTERATION / Ti ❑ REVISION /DEFERRED ORIGINAL PERMIT PROJECT ADDRESS _ 117-340 1ZEC-%tQ �► RD, APN -,0-oc- OWNER NAME b0ONE � PH a 3 t l I4 &J G ��O R- (, I%.. Loo STREET ADDRESSCITY, STAT , ZIP - -L&4 O Rb FAX CONTACT NAME y P NE q E-MAIL 1 6 16 a- Lw—1®� � C � tri i 'fig i3l i31��°t i STREET S CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ONTRACTORAGENT ❑ ARc=c-r ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CO . CTOR NAME GE.P-T 5 A L AZ AfZ- LIt�I,SE�$ER 77;;7� BUS. LIC k COMPANY NAMEE-MAIL d. i"T\144dY`, '�_,;,Aq i'-C++hJisR� P, �4c ' i?1�J5Ut4Z FAX STREET DD ESS CITY, STATE, ZIP OI�B ARCHITECT/ENGI EER NAME LICENSE NUMBER BUS. LIC R COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK a e EXISTING USE PROPOSED USE CONSTR TYPE r STORIES USE TYPE OCC, SQ.FT. VALUATION(s) (3P 0- G Sthh Root EXISTG AREA q, O' Q NEW FLOOR � AR b yy_ -1 DEMO ®� AREA a P ,9 TOTAL NET ARE '( BATHROOM - C6HFN OTHER REMODEL ARE4 dg, REMODEL AREA ,q l REMODEL AREA. p PORCH AREA DECK AREA TOTAL DECKMORCH AREA I_p GARAGE AREA: DETACH ❑ATTACH A( - - R DWELLINGUNTS: IS A SECOND UNIT F1 -1 SECOND STORY n7r-T- �. BEING ADDED? ❑NO ADDITION? NO PRE -APPLICATION ElYES IF YES, PROVIDE COPY OF I IS THE BLDG AN ❑ YES EICHLER HOME? [3 N0 RECEI VEDBY ,- -. ' 1 OTATenVUATION: PLANNING APPL ❑NO PLANONING APPROVAL LETTER rr By my signature below, I certify to each of the following: I am the property owner or authorized agent to a on the perry 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 accurate. I agree to comply with all applicable local ordinances and state laws relatine building co ction. I authorize representatives of Cupertino to enter the above -identified vroperty for inspection purposes. ,� Date:- Signature of Applicant/Agent: SUPPLEME111AL INFORMATION REQUIRED OYER THE COUATER r IlUIiDITiGPLAIIl2EVIEVd New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building for new building. EXPRESS PLANI�II�G PiATv REYLEW permit commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTAI�DAxD ❑ P`vBLlcmoxxs _ form if any Hazardous Materials are being used as part of this project. J) n> rT Copy of Planning Approval Letter or Meeting with Planning prior to LATtcE❑ � rq�JOR n •r tIRF �-SAnzTI SRICT su_bmittal of Building Permit application. .L;.EI�S'IRO'15SEATAL:AEALTfi�+` _.._ BldgApp_2011.doc revised 06121/11 law CITY OF CUPERTINO FEE ESTIMATOR - BUILDING n1l'VES-101V AI ADDRESS: ADDRESS: 22340 REGNART RD D DATE: 04/1512015 REVIEWED BY: MELISSA APN: 366 40 007 #: -VALUATION: "PE MIT MIT Ty PL C Building Permit PLAN CHECK TYPE: Alteration 1 Repair PRIMARY USE: SFD or Duplex PENTAMATION hrs IR3SFDADD PERMIT TYPE: A WORK INSTALL (N) PREFABRICATED SUN ROOM $0.00 SCOPE Permit Fee: $0.00 4&"cA Pla)" Fee" Phm�b. Chwck NOTE: This estimate does not include fees due to other Departments (Le. Planninz, ph?rs C"I"ef, 'Elge-wm irks. Fire. Sanitary Sewer District. School District, etc.). These fees are based on the preliminary infariwafinn avahlablp ly"d d7r,' n"117 an 00i"I"to I-A.ff fh' n,.f in -4J.11 ;.r, FEE ITEMS (Fee Resolution 11-053 fff. 7/1/13 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-2-00-1 s.f. Patio Cover / Sun Room $859.001 IPATIOENCW I Wood, Enclosed Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 F2_00 S.f. Patio Cover / Sun Room $716.00 1PATiowoo7D Wood Permit Fee: $0.00 Suppl. Insp. Fee.(F) Reg. 0 OT -f 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 GUnswilction 0 G Work Without Permit? 0 Yes (F) No $0.00 Advanced PlgLining_Fe�e. $0.00 Select a Non -Residential G Building or Structure 0 Tre.Yvel Strong Motion Fee: IBSEISMCR $10.66 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $14.66 $1,575.00 $1,589.661 Revised: 04/0112015 J. CALGREEN RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPER71N0 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building (@cupertino.org PURPOSE: 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 requirements of CALGreen. CUPERTINO �I Building Droartmeni Project Name: Project Address 'o-/ 0 or Z a 1.-1 (Lec �c, r APR 15 2015 Project Description: IC, %-) REVIEWED I -OR CC:7E (l)IMPLIANCE Reviewed By. 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 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 skull complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this' checkfist and submit the completed form to the Building Inspector. APR 1-4 z01� 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. C U Page 1 of 5 CulGreen_2014.doc revised 11104114 A4.2 General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum ❑ ❑ standard design required by the California Energy Standards. A4.3 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 CulGreen_2014.doc revised 11104114 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 ❑ 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 ❑ compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings E:1shall be compliant with product weighted MIR Limits for ROC and other toxic compounds. Page 3 of 5 CulGreen_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 ❑ ❑ VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area defined in receiving resilient flooring shall comply with the VOC-emission limits d'❑ 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 . SPECIAL 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 ❑ ❑ 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 CnlGreen_2014.doc revised 11104114 Project Name: Project Address: Project Description CALGREEN SIGNATURE DECLARATIONS rocs.— t'vtC4-A I a-- n,Zo�` 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 byftt�� of Cupertino. U er s z5ignarure Owner's Na L/ se Print) De'gn Pr ssiona'l''s/ ignature vV y Design Professional's Name (Please Print) Signature of License Professional responsible for CalGreen compliance Name of License Professional responsible for CalGreen compliance (Please Print) Em I Address for License ProfessioV& responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Date %2S Phone Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date IName of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 Ca[Green_2014.doc revised 11104114 ICC -ES Evaluation Report ESR -2445 Reissued June 2014 This report is subject to renewal August 1, 2015. www.icc-es.orq 1 (800) 423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council® DIVISION: 06 00 00—WOOD, PLASTICS AND COMPOSITES Section: 06 12 00—Structural Panels REPORT HOLDER: FOUR SEASONS SOLAR PRODUCTS 5005 VETERANS MEMORIAL HIGHWAY HOLBROOK, NEW YORK 11741 (631) 563-4000 www.fourseasonssunrooms.com EVALUATION SUBJECT: CONSERVADECK STRUCTURAL INSULATED PANELS 1.0 EVALUATION SCOPE Compliance with the following codes: ■ 2012, 2009 and 2006 International Building Code® (IBC) ■ 2012, 2009 and 2006 International Residential Code® (IRC) Properties evaluated: Structural 2.0 USES Conservadeck Structural Insulated Panels (SIPs) are used as structural insulated floor panels of enclosed structures installed over nonhabitable space. 3.0 DESCRIPTION 3.1 General: Conservadeck SIPs are factory -assembled sandwich panels consisting of oriented strand board (OSB) facings with an expanded polystyrene (EPS) foam plastic core material. The panels are 4 feet (1.2 m) wide and vary in length from 8 feet to 16 feet (2.4 m by 4.9 m). Panel thicknesses are 61/2, 7, 83/6, and 87/6 inches (165, 178, 213, and 225 mm). The 61/2- and 83/6 -inch -thick (165 and 213 mm) panels are faced with a single layer of OSB on each side, while the 7- and 87/6 -inch -thick (178 and 225 mm) panels are faced with an additional layer of OSB on the top (walking surface) side. 3.2 Materials: 3.2.1 Expanded Polystyrene: The core thicknesses are 55/6 and 73/6 inches (143 and 187 mm). The core material is a nominal 1.0 -pound -per -cubic -foot, Type I, expanded polystyrene foam plastic board complying with ASTM C578. The board is supplied by the manufacturer identified in the approved quality control documentation. The foam plastic has a flame -spread index of 25 or less and a maximum smoke -developed index of 450 or less when tested in accordance with ASTM E84. 3.2.2 Facings: The facing material (both factory- and jobsite-applied) of the panels is 7/16 -inch -thick (11 mm) OSB sheathing classified as Exposure 1, having a span rating of 24/16 and complying with U.S. DOC PS 2 and the requirements in the approved quality documentation. 3.2.3 Adhesive: The facing material is factory -laminated to the panel core with a Type Il, Class 2, adhesive as described in the approved quality control documentation that complies with the ICC -ES Acceptance Criteria for Sandwich Panel Adhesives (AC05). 3.2.4 Splines and Plates: Splines and plates must be minimum No. 2 grade, sawn Douglas fir -larch lumber with a minimum nominal specific gravity of 0.50. The splines and plates must be nominally 2 -by lumber, fitted for each EPS foam plastic core thickness. 4.0 DESIGN AND INSTALLATION 4.1 Design: 4.1.1 Allowable Loads: For use in allowable stress design, the allowable uniform gravity (dead and live) loads and upward wind loads for the panels are as set forth in Tables 1 and 2. Use of the panels to resist any other load conditions (such as axial compression or tension forces due to horizontal wind loads, or use as a floor diaphragm to resist seismic or horizontal -wind loads) is outside the scope of this report. 4.1.2 IRC: When panels are installed under the IRC, an engineered design is required in accordance with IRC Section R301.1.3. 4.2 Installation: 4.2.1 General: Conservadeck SIPs must be installed as the floor of the enclosed structure with the panel length perpendicular to the supporting members and without transverse joints. The panels must be connected to each other along the panel edges by insertion of the lumber splines described in Section 3.2.4. The lumber spline and plates must be secured between the panels with 8d cooler [0.113 -inch -diameter -by -23/6 -inch -long (2.9 mm by 60 mm)] nails at 8 inches (203 mm) on center. The top surface of the floor panels must be covered by a thermal barrier approved by the code official, such as 3/4 -inch -thick (19.1 mm) plywood installed on the top surface. ICC -ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or implied, as to any finding or other matter in this report, or as to any product covered by the report. Nss Copyright ® 2014 Page 1 of 4 ESR -2445 I Most Widely Accepted and Trusted Page 3 of 4 TABLE 1—ALLOWABLE LOADS FOR 5% -INCH -THICK EPS FOAM CORE CONSERVADECK FLOOR PANELS 1,2 (psf) PANEL SPAN (ft) 3 psf SUPERIMPOSED DEAD LOAD 7 psf SUPERIMPOSED DEAD LOAD Gravity Loads Wind Uplift Load Gravity Loads Wind Uplift Load Allowable Allowable Floor Live Load Floor Live Load Single OSB Double OSB' Allowable Allowable Floor Live Load Floor Live Load Single OSB Double OSB' 7 85 84 38 81 80 40 8 71 72 33 67 68 36 9 56 62 30 52 1 58 33 10 45 49 28 41 45 30 11 N/A 40 25 42 41 TABLE 2—ALLOWABLE LOADS FOR 7'/e -INCH -THICK EPS FOAM CORE CONSERVADECK FLOOR PANELS''2 (psf) PANEL SPAN (ft) 3 psf SUPERIMPOSED DEAD LOAD Gravity Loads Allowable Allowable Wind Uplift Load Floor Live Load Floor Live Load Single OSB Double OSB' 7 psf SUPERIMPOSED DEAD LOAD Gravity Loads Allowable Allowable Wind Uplift Load Floor Live Load Floor Live Load Single OSB Double OSB' 7 85 83 38 81 79 40 8 73 72 34 69 68 36 9 64 63 30 60 59 33 10 57 56 28 53 52 30 11 51 50 26 47 46 28 12 46 45 24 42 41 26 13 40 N/A 22 For SI: 1 inch= 25.4 mm; 1 foot= 305 mm; 1 psf-- 47.9 Pa. Notes: 'All allowable loads provided are uniform applied loads. 2Deflection limit for live load is L/360. Deflection limit for dead plus live load is L/240. Deflection limit for wind load is L/360. Minimum allowable live load presented is 40 psf ' See Section 4.2.2 for installation requirements. ICC -ES Evaluation Report ESR -2445 CBG and CRC Supplement Reissued June 2014 This report is subject to renewal August 1, 2015. www.icc-es.org 1 (800) 423-6587 1 (562) 699-0543 A Subsidiary of the International Code Council® DIVISION: 06 00 00—WOOD, PLASTICS AND COMPOSITES Section: 06 12 00—Structural Panels REPORT HOLDER: FOUR SEASONS SOLAR PRODUCTS 5005 VETERANS MEMORIAL HIGHWAY HOLBROOK, NEW YORK 11741 (631) 563-4000 www.fourseasonssunrooms.com EVALUATION SUBJECT: CONSERVADECK STRUCTURAL INSULATED PANELS 1.0 REPORT PURPOSE AND SCOPE Purpose: The purpose of this evaluation report supplement is to indicate that the Conservadeck Structural Insulated Panels, recognized in ICC -ES master evaluation report ESR -2445, have also been evaluated for compliance with the codes noted below. Applicable codes: ■ 2013 California Building Code (CBC) ■ 2013 California Residential Code (CRC) 2.0 CONCLUSIONS 2.1 CBC: The Conservadeck Structural Insulated Panels, described in Sections 2.0 through 7.0 of the master evaluation report ESR -2445, comply with CBC Chapters 3, 8, 23 and 26, provided the design and installation are in accordance with the International Building Code provisions noted in the master report and the additional requirements of CBC Chapters 3, 8, 23 and 26, as applicable. The Conservadeck Structural Insulated Panels have not been evaluated under CBC Chapter 7A for use in the exterior design and construction of new buildings located in any Fire Hazard Severity Zone within State Responsibility Areas or any Wildland-Urban Interface Fire Area. 2.2 CRC: The Conservadeck Structural Insulated Panels, described in Sections 2.0 through 7.0 of the master evaluation report ESR -2445, comply with CRC Chapter 3, provided the design and installation are in accordance with the International Residential Code provisions noted in the master report and the additional requirements of CRC Chapter 3, as applicable. The Conservadeck Structural Insulated Panels have not been evaluated under CRC Section R327 for use in the exterior design and construction of new buildings located in any Fire Hazard Severity Zone within State Responsibility Areas or any Wildland-Urban Interface Fire Area. This supplement expires concurrently with the master report reissued June 2014 ICC -ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed asan endorsement of the subject of the report or a recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or implied, as 1744 to any finding or other matter in this report, or as to any product covered by the report Copyright ® 2014 Page 1 of 1 Originally Issued: 09/2011 Revised: 08/29/2014 Valid Through: 09/2015 EVALUATION SUBJECT: Series 230 Sun & Stars/Shade System REPORT HOLDER: Four Seasons Solar Products LLC 5005 Veterans Memorial Highway Holbrook, NY 11741 www.fou rseasonssunrsord IBC Section 104.11.1 or other nationally recognized Patio Enclosure certification program accepted by IAPMO Uniform Evaluation Service. The Series 230 Sun & Stars Straight Eave, Curved Eave, Cathedral and Victorian Conservatories consist of an aluminum wall system with aluminum rafter system supporting insulated glass units. CSI Division: 13 SPECIAL CONSTRUCTION CSI Section: 13 34 00 Fabricated Engineered Structures 1.0 SCOPE OF EVALUATION 1.1 Compliance to the following codes & regulations: • 2012 International Building Code® (IBC) • 2012 International Residential Code® (IRC) • 2009 International Building Code® (IBC) • 2009 International Residential Code® (IRC) • 2006 International Building Code® (IBC) • 2006 International Residential Code® (IRC) • 2013 California Building Code® (CBC) • 2013 California Residential Code® (CRC) 1.2 Evaluated in accordance with: • ICC -ES Acceptance Criteria for patio Enclosures (AC -340) approved June 2012, revised August 2013 1.3 Properties assessed: • Structural 2.0 PRODUCT USE Four Seasons Solar Products' Straight Eve, Curved Eave, Cathedral and Victorian patio covers are residential attached patio covers used as recreational, outdoor living, enclosed structures conforming to Appendix I of the IBC and CBC, and Appendix H of the IRC and CRC, and not as carports, garages, storage rooms or habitable rooms. The patio enclosures shall be constructed in accordance with the drawings accompanying this report (general drawings dated January 1, 2011, and specific room drawings dated January 10, 2011, all revised February 16, 2014). The patio enclosures require openings in accordance to Appendix I of the IBC and CBC, and Appendix H of the IRC and CRC. 3.0 PRODUCT DESCRIPTION The Series 230 Sun & Shade Straight Eave and Cathedral models consist of an aluminum wall system with a laminated sandwich panel roof. The laminated sandwich panels shall be constructed in accordance with a listed evaluation report from an approved source as defined in 3.1 Product information: The Series 230 Sun & Stars/Shade patio enclosure systems are recognized as structures complying with the IBC, IRC, CDC, and CRC. The patio covers, all of which have either laminated sandwich panel roofs or glass roof panes as described in the set of plans accompanying this report, resist lateral loads from wind and seismic loads under the limits of this report and attached plans, but shall be attached to an existing structure to be capable of resisting the lateral loads imposed by the patio enclosures system. Attached patio covers, where considered, shall be open on three sides. 3.2 Material Information 3.2.1 Glazing: The glass panes, which are manufactured by Cardinal Glass Industries, are supplied with each patio cover enclosure system. All glass is tempered and complies with Chapter 24 of the IBC and CRC and Section R308 of the IRC and CRC. 3.2.2 Roof Panels: The laminated sandwich roof panels shall be approved and listed in an evaluation report from an approved source as defined in IBC Section 104.11.1 or other nationally recognized certification program accepted by IAPMO Uniform Evaluation Service. 3.2.3 Conservadeck: The conservadeck shall be approved and listed in an evaluation report from an approved source as defined in IBC Section 104.11.1 or other nationally recognized certification program accepted by IAPMO Uniform Evaluation Service. 3.2.4 Wall Panels: The laminated sandwich panels shall be constructed of 0.024 -inch aluminum facing and 1.0 pcf (16.0 kg/m3) expanded polystyrene foam plastic insulation and conform to the minimum specification specified in the drawings. 3.2.5 Aluminum, Steel, and Fasteners: The aluminum, steel, fasteners, and sealant minimum specifications are specified in the drawings. 4.0 DESIGN AND INSTALLATION 4.1 The Series 230 Sun & Shade and Sun & Stars Patio Enclosure Systems (Straight Eve, Curved Eave, Cathedral and Victorian designs) described in this report comply with Appendix I of the IBC and CBC, and Appendix H of the IRC and CRC, subject to the following conditions: The product described in this Uniform Evaluation Service (LIES) Report has been evaluated as an alternative material, design or method of construction in order to satisfy and comply with _ the intent of the provision of the code, as noted in this report, and for at least equivalence to that prescribed in the code in quality, strength, effectiveness, fire resistance, durability and safely, as applicable, in accordance with IBC Section 104.11. Copyright ® 2014 by International Association of Plumbing and Mechanical Officials. All rights reserved. Printed in the United States. No part of this publication may be reproduced, stored in t an electronic retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher Ph: 1-877-41ESRPT • Fax: 909.472.4171 • web: www.uniform-es.org • 5001 East Philadelphia Street, Ontario, California 91761-2816 — USA Originally Issued: 09/2011 Revised: 08/29/2014 Valid Through: 09/2015 7.0 IDENTIFICATION A label shall be affixed on at least one of the following: product, packaging, installation instructions or descriptive literature. The label shall include the company name or trademark, model number, and the IAPMO Uniform ES Mark of Conformity the name of the inspection agency (when applicable) and the Evaluation Report Number (ER - 110) to identify the products recognized in this report. A die -stamp label may also substitute for the label. Either Mark of Conformity may be used as shown below: 1ApMO UES ES 0® or TM IAPMO ER #110 Brian Gerber, P.E., S.E. Technical Director of Uniform Evaluation Service Richard Beck, PE, CBO, MCP Director of Uniform Evaluation Service GP Russ Chanyy CEO, The IAPMO Group For additional information about this evaluation report please visit www.uniforni-es.org or email at info,W uniform-es.ora Page 3 of 3