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14100156-F CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 880 E ESTATES DR CONTRACTOR:ALL CONSTRUCTION PERMIT NO: 14100156 OWNER'S NAME: LIM JUDY TRUSTEE&ET AL 2971 NEAL AVE DATE ISSUED:03/11/2015 OWNER'S PHONE: 4088320322 SAN JOSE,CA 95128 PHONE NO:(408)605-1212 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL 0 COMMERCIAL CONSTRUCT A ONE STORY ADDITION(636 SQ FT); icense Class 43 Lic.# INTERIOR REMODEL(400 SQ FT);PANEL UPGRADE(200 Contractor 7&6 L l G-1u^i Date l/f� AMP);RELOCATE FURNACE. I hereby affirm that I am licensed under the provisions o 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. Sq.Ft Floor Area: Valuation:$279000 have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:36924007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned properly for inspection purposes. (We)agree to save 180 DAYS F M LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:3 A�� with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ` . RE-ROOFS: Date All roofs shall be inspected prior to any roofing material being installed.If a roof is MC: installed without first-obtaining an inspection,I agree to remove all new materials for inspection. ❑ 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,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 11 art - ,; f��� permit is issued. s' �10n uth�orze ti Date: I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 880 E ESTATES DR CONTRACTOR:ALL CONSTRUCTION PERMIT NO:14100156 OWNER',S NAME: LIM JUDY TRUSTEE&ET AL 2971 NEAL AVE DATE ISSUED:03/11/2015 OWNER'S PHONE: 4088320322 SAN JOSE,CA 95128 PHONE NO:(408)605-1212 JOB DESCRIPTION:RESIDENTIAL COMMERCIAL LICENSED CONTRACTOR'S DECLARATION CONSTRUCT A ONE STORY ADDITION(636 SQ FT); License Class ^ Lic.# Tq M0 INTERIOR REMODEL(400 SQ FT);PANEL UPGRADE(200 �(I (Q�t SY s, M Date �'Z may' AMP);RELOCATE FURNACE. Contractor '7 11 V#1-REMOVE 3 SKYLIGHTS,RELOCATE BEDROOM WINDOW& I hereby affirm that I am licensed under the provisions of Chapter 9 CREATE(N)EXTERIOR GARAGE DOOR-ISSUED 7/2/15 (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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$279000 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36924007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FRO ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ' granting of this permit. Additionally,the applicant understands and will comply stuff Date: with all non-point source regulations per the Cupertino Municipal Code,Secti 9.18. i RE-ROOFS: Signat _ Date All roofs shall be eeted 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. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505 253,and 4. Section 3700 of the Labor Code,for the performance of the work for which this —45 permit is issued. Owner or authorized ag Date I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 AD C014STRUCTI®N PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISIO \U 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(@cupertino.org \ CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEF ED OPJGINAL PERMIT# PROJECT ADDRESS - PN# OWNER NAME PHONE UU-1hCO V /JLI� - STREET ADDRESS CITY, STATE,ZIP ll�J h bj;AX I f� CONTACT NAME �,,y � 9 „�/- A­PHIT)e log- /��� E-�MJAIL, n _` j� `..�I- I A STREET ADDRESS IU4 V v'� CITY,STATE,ZIP / l� J �MI,/V/A�TI`/b/+l'�GCTII FYA,X ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# W ftil, C COMPANY NAME E-MAIL FAX rea zic es r� leu e STREET ADDRESS n ni� N� CITY,ST ,ZI PHONE �j R 7CI3 22 DESCRIPTION OF WORK U b l$ [N c wo 0 t2p r / W Gam"► D t,1\/1W6 Env . G(t96WIF, M a P Zo-0 hiy1, EXISTING USE PROPOSED USE CONSTR TYPE #STORIES new KE� s f•fes I `, USE TYPE OCC. SQ:FT. VALUATIONNE IXIST ($) IUIAL AREAG'2 Vl ARE FLOORK•& D�0_ � Y NET AREA 2 LP BATHRO M KITCHEN ,1 OTHER REMODEL AREA REMODEL AREA ,�� REMODEL AREA 4 PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE - A: EIDETACH ¢ ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STO Y ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YESRECEIVED BY:. TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property 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 relating to build' constructio I aut brize representatives of Cupertino to enter the above-i ntifiedropertyfor'nspection purposes. Signature of Applicant/Agent: Date: I a,6 SUPPLEMENTAL INOMATION REQUIRED PL N CHECkTYPE' ROUTINGS IP _New SFD or Multifamily dwellings: Apply for demolition permit for �] oV>iR-TH><courlT>iR`-, DING PLAN vlw ` existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0.^EXs';Ess A 1Yir:G PLANRFVtrW _Commercial Bldgs: Provide a completed Hazardous Materials DisclosureSTArmaRD `PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. "Inxs>iFIRE _Copy of Planning Approval Letter or Meeting with Planning prior to ❑�MAJOR'--, AVITARY sEw>x DISTRICT " submittal of Building Permit application. 0 ENNTRONMENTAL HEALTH BldgApp 2011.doc revised 06/21/11 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• building „cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI REVISION/DEFERRED ORIGINAL PERMIT n PROIECr ADDRESS Q r APN R OWNER NAME PHONE E-MAIL Lo�4 Jvd Lien 06CP-0327- STREET ADDRESS CITY, STATE ZIP FAX () nrt• C� CONTACT NAME PHO® (0� 2 E-MAIL _73 STREET ADDRESS CITY,STATE,ZIP FAX OWNER ❑.OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CON7RACTORAGENT ❑ ARCHITECT El ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LIC ENS �4BER 10ENSETYPE BUS.LICR A L;Cegir% ratrt10r 35 2 COMPANY NAMELL �C�°' E-MAIL `(3 I I'�1` gt.®.J D •eut� FAX STREET ADDRESS CITY,STATE,ZIP / PHONE Ave. -e/ L ARCHITECTIENGINEERNA2vfE LICENSE NUMBER BUS.LIC R COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK f0 fes/.tltGl tJuJ �C4'�'�tl/I � / ��tnnua„ltt c tr S t — EXISTING USE PROPOSED USE CONSTRTYPE ISTORIES USE TYPE OCC. I SQ.FT. VALUATION(S)' EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA -- BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH E ATTACH R D\VELLDNG UNITS: IS A SECOND UNIT (]YES SECOND STORY ❑YES BEING ADDED? ENO ADDITION? ENO PP,E-.S.°PLICATION ❑1 FS IF YES,PROVIDE COPY OF IS THE BLDG AN El YES - - TAL, PLANNING APPL-� ENO PLANNING APPROVAL LETTER EICHLER HO ME? []NO By my signature below,I certify to each of the following: I am the property o or authorized aeent to a pro own s behalf. e read thi application and the information I have provided is correct. I have read escription of Vdork and ve i ' e. I agree to co all a le local ordinances and state laws relating to building construction. I authorize representatives'of Cupertino to enter the above-identified prop pection purposes. Signature ofApplicant/Agent: _ Date: ! �� SUPPLEMENTAL MTFOR-MATION REQUIRED _ r Al.c eKT�PE ROITrinc.sLlPk ' New SFD or Multifamily dvvellings: Apply for demolition permit forr r: "❑-md— P;OVERTH)<COUhTER �BIIII.DI)\GPLANREVIEFP” existing building(s). Demolition permit is required prior to issuance of building z _ permit for new building 1] MON— k' p _ EXPRESS 0 PLAhT]?�GELAN REyIEFV _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Q sTAnaRD ,,,` ❑ PUBIacvFoiixs form if any Hazardous Materials are being used as part of this project. € S 4Rti s FI> DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to = . ❑=MA70R SAI�7TARYSER` RI ,j submittal of Building Permit application. - _ �� ERDISTCT _ z r : EI�YIRONMEI�T_4LFIEATiTA ,- BIdg,4pp_2011.doe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION JADDRESS: 880 a estates dr DATE: 10/27/2014 REVIEWED BY: Mendez N: BP#: *VALUATION: 1$279,000 YPERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY 2nd Unit? Yes .; No PENTAMATION USE: SFD or Duplex OTC? 0 Yes (E)No PERMIT TYPE: 1 R3SFDADD WORK 646 sq ft addition to side of sfdwl to include master suite & living room; remodel 400 sq ft through out SCOPE panel upgrade 200 amp, relocate furnace. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,III-B,IV,V-B 646 ft ' IR3PLNCK $1,666.00 IR3INSP TOTALS: 646 $2,654.00 $1,666.00 y IYIECH,HOURLY Yes No PLi1MB,IOURLY F Q Yes..u,`� No ELEC;`HO;iT12LY4 Q ,Yes G Q No;, Mech.Plan Check 0.0 hrs $0.00 Plim;h. Plan Checf, Elec.Plan Check 0.0hrs $0.00 Mech.Permit Fee: 1MPERMIT Elec.Permit Fee: ]EPERMIT Other Mech.Insp. 0.0 hrs $48.00 Other Ph;m/*Insp. Other Elec.Insp. IEIhrs $48.00 1.1och, 1r51v. Fe, PhIn;b. hula. Fee: L;iec.lnst:>. f�'en: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are'based on the prelimina information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/132 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,654.00 DKI s.f. Remodel,Other Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $503.00 1REMRESOTII i PME Plan Check: $0.00 F-2007 amps Electrical Permit Fee: $1,666.00 $48.00 1 IBELEC200 Services Suppl. Insp.Feer) Reg. Q OT 0.0 1 hrs $0.00 Mechanical PME Unit Fee: $0.00 $143.00 1MFR=<100 Furnace,Forced-Air PME Permit Fee: $96.00 Consiruction;Tax . ,I(Iminrstrati ve Fee: 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning_Fee: 1PLLONGR $90.44 Select a Non-Residential Travel Documentation Fee: 1TRAVDOC $48.00 Building or Structure i Strong Motion Fee: 1BSEISMICR $36.27 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $12.00 s>11BTOTArsµ $4,602.71 $694.00 TOTAL FEE. 71 Revised: 08/20/2014 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 880 a estates dr DATE: 07/02/2015 REVIEWED BY: melissa APN: 369 24 007 BP#: 14100156 '`VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION 1GENRE USE: PERMIT TYPE: WORK REV# 1 - REMOVE 3 SKYLIGHTS RELOCATE BEDROOM WINDOW& CREATE N EXTERIOR SCOPE GARAGE DOOR- ISSUED 7/2/15 Xh,ch, Plan(.heck Phinrb. Plan Check Glec.Plan Check' :L1cch. Pernril/�i;e: Plumb. Permit Fee: Iilec. Perini!Fee: 0/1,ier rllech. Insp. Other'Phrmb Insp, Other Glee.Insp, Wech,Insp. Flee: Phanab. hasp. Fie: Efec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Theseees are based on the prelimina information available and are on an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (j) No $0.002� hours Plan Check,Hourly Suppl. PC Fee: 0 Reg. 0 OT0.0 hrs $0.00 $286.00 1sTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. C) OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Q Work Without Permit? 0 Yes (E) No $0.00 E) Advanced Planning_Fee: $0.00 Select a Non-Residential E) Travel Doe'unenlalion Fees: Building or Structure 0 Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission.Fee: $0.00 "sUBTOTALS:,; $0.00 $286.00 roTAL FEZ.' $286.00 Revised: 07/01/2015 N .. ......-.,_.,...........»..,»._..,...._,................. -........---._._......... I I Ba�dlcling Department City OfCupertino i 0300 Ib ra,Aveuue C'ufaertino,CA X35014-3255 'I`elephone:408.777-3228 U P E RT I Fax:408-777-3333 CONTRACTOR SUBCONTRACMR LIST LJ(�I3 E' DDRES 880E Estates Drive I'f ft I f a 14100156 E... C}WNf fC S NA M[ Lim Judy Trustee&ET AL 1 PHONE#4086051212 Cif rd F'iAI ( C YP t�[Z C f�t:;ALL Construction l3[3�s1��} ,�, LICENSE 1135723 ADDIC I S 2971 Neal Avenue,San Jose,CA 95128 I C (g 1 f}�{ C f 195128 _.........-.._ _ ._._ ...�. _ _ _ ___.,__-_. -._ °'Our municipal cote i-egtiire.s all biisiae:ses working in the city to have as City of Cupertino ertino business license, NO t IMLIANC, 3=IMIM OR FINAL, CSC(..(.l'XNC a' aNSPF.(--r!(.ta) WILL HE 8(. *:IWLI?.D 'MIM GE.Nl-'lRAL C:;t.)NT.RAC.:.4"OR AN!) :LL. WJ13 ",.OTR. CTC3 ,.S I3r`aV.E C3Fa"f'AINED A CITY OF C.t)PERTI O MJSINESS LICENSE. f arta not using etre-saalzcaztalasgas lase°s: ...__._ .»»_..__.... . ......... ........ _..... ..._..,._. . S'ssaaatua•e Date 1 Please cheek applicable swbc 'tats et r,,�and complete the following information: ._,..»._._ t C„' C I i BUSI ,"NIM IISI ESS 1ACENSE . X talbin�;ts �, i',,hlf��ozk Wood Talents REF#:APOACEIF5B87 [ __..................____.___...__» � �.___._._ i X Cement 1=inislain� Green Sierra Landscaping #35887 Electricat X ; Excavation Green Sierra Landscaping #35887 _.._ _.._.._...__ __.-- f l CT1C[a1b _ _ _— -... I lvori�m, C:ati Lrc_ting i Linolearn = Wood � X Glass a s s Glazing C&Z Glass �� �C.�F9�3C�(siO3� ' _._.___ __...... __.._._... ._...... Heating Petty Heat&Air Conditioning ` Insulation i i/� ........... ...........,....�..._....... ...... ............. Laindsc Lping -__...... .... Lathing Masonry j I sainting Wallpaper ........._.._.__._.__...................___......__...._ _ _ _._.._.__. _.............._............._........-_ __._...__ __.__..................._.....__.._.._................. ! Paving ._.._.»._....�............ --_--- ...».. �_..v__ . i i Platit.e ing ......_._. Plumbing X Roofino TNT Roofing #22988 Sepfic.'Fink ......._. �.»k.._. t»» Slate,McLal X ` Sbeet Dock Severiano Drywall i*Has left the country and closed company*i d' �.._.f_____.�._,. .._..._.__................»._� ........____.__ ...__._.._. ._..�___. .._ ..__. . _._ .,....._ _.................. Owner"C:e3iadtactoAT Signature i"We 3 CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CUPRTINO 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 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. Project Name: KX-t- %{PJ.V kV12efl b A Project Address: � �7�1 !� C l,c-6 �f 1� CA Project Description: &;(Q 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 reqMJPetyyQ6 described herein is properly planned and implemented in the projeli C1 IN 2. The licensed professional, in collabor "k the owne Aldi � -Oessional shall initial Column 2 of this checklist sign date Sect oInn - g ''_1 *p�esign Verification at the end of this checklist and have the checklist printed on the approved plans W.1, �rojON, 10 205 3. Prior to final inspection by the Building department, the licensed professional shall complete Column 3 and sign and date Section 2- ImplemeLntafiGrE ;VarMea<tianlfat(tb-eVdMM, checklist and submit the completed form to the Building Inspector. kee1eweo By. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Requirements A4.1 PLANNING -AND DESIGN Planning°an ®esigia Site ®eveloprnent k sz . s t 11 4.106.2 Storm water drainage and retention during construction. A plan is El 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. 015 MAROFFICE COPY Page 1 of 5 CalGreen_2014.doc revised 11/04/14 ENERGY EFFICIENCY A4.2 ; �Gev>eral 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. El ' A4.3 WATER EFFICIENCYAND CONSERVATION IndoorJWaterl�se 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. JZ 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, El and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen 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. MATERIALCONSERVATiON AND RESOURCE Enhanced ®urabilrty and Reduced IWaintenance § '` r VA e 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. .C�nstruct�®nry'Waste Reductioin9 ®iand'R 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 Y� enforcing agency. r �utldir g Nlaantenance and mperation° ' 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 ENVIRONMENTALQUALITY Fireplaces Y ,. �x3 . �w a 4.503.1 General. Install only a direct-vent sealed-combustion gas or sealed wood-burning fireplace, or a sealed woodstove. Pollutant Cartr®1 y ¢' 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 bej compliant with VOC limits. lu 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_2014.doc revised 11/04/14 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. jo 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. InterioralVlatsture 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 �fj ❑ materials used in wall and floor framing is checked before enclosure. Ej IndoortAir Quality and Exhaust Q 4 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the ❑ building are provided in every bathroom. `E! vironrmental C0'f6it - 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 ,R 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 [/7 ❑ discipline they inspect and verify. `Verifications '.. "y", 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( El which show substantial conformance. Implementation verification shall J�-� be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 CalGreen_2014.doe revised 11/04/14 n d CALGREEN SIGNATURE DECLARATIONS Project Name: Z//Y! �,�`� Project Address: (Q© 6 E ow v�` v �`I `��i CA Project Description: 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. 3 - (C) wner's i nat e \ Date b m Thr Owner's Name (Please Print) Desig nal's Signature Date PtqL Design Professional's Name (Please Print) Signatuce�of k?'r Pi`df's o of sp r�sibfi�`of r Ca Green co pii r e-- L. Nar�a�of$is eens�eSP�`�fe��rona�po`rr�'i151e f�ruC�`9`'�/�`en c in�iliar�ce�(Rlease3l�rin h€� E d.Addressxfor,,Lice-nse.l?ro sional„fe_spo si�ble fczr- _a li en co�mgliance 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