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B-2016-1906
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1906 10198 RICHWOOD DR CUPERTINO, CA 95014-3314 (369 08 029) DE ANZA BUILDERS CAMPBELL, CA 95008 OWNER'S NAME: SEETHARAM SHIRISH AND SHIRISH SUSHMA TRUSTE DATE ISSUED: 07/28/2016 OWNER'S PHONE: 408-242-6447 PHONE NO: (408) 865-0222 LICENSED ONT A TOR' DECLARATION BUILDING PERMIT INFO - License Class a Lic. #943227 Contractor DE ANZA BUILDERS Date 02/28/2018 X BLDG —ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH X RESIDENTIAL COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION 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 aga(aapplica st sai City in consequence of the granting of this permit. Additionally, the t understands and will comply with all non -point source regulatio per he Cupertino Municipal Code, Section 9.18. Date 7/26/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) z. 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. z. 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, atter 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 7/26/2017 REMODEL LIVING ROOM, FAMILY ROOM, DINING ROOM AND RELOCATE KITCHEN AND ADD SKYLIGHT 864 SQ FT, ADD (N) BAY WINDOW AT DINING ROOM, COLUMNS AND GABLE ROOF AT ENTRY PORCH, REMOVE FIRE PLACE IN DINING ROOM REV #1 - CHANGE ENTRY DESIGN - ISSUED 7/26/2017 Sq. Ft Floor Area: Valuation: $60000.00 "N Number- Occupancy Type: 369 08 029 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by ABBY AYENDE 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: 7/26/2017 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(.)4"uI store or handle hazardous material. Additionally, should I use equipmento devices which emit hazardous air contaminants as defined by the Ba Area Air Quality Management District I will maintain compliance with the Cupertino Mcipal Code, Chapter 9.12 and the Health & Safety Code, ections 25 05, 25533, and 25534. Owner or authorized agent: Date: 7/26/2017 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 F. RATION I understand my plans shall be used as public records. Licensed Professional +CUP15= RTI tD CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 building cDcupertino.orc LJ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI 71REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS APN # OWNER NAM�F 1 THOCIE E-MAIL `�vh4<v �F. vi•�i.�j��.A1..f��,r `i ®PID _ZAIZ (etA �j►�iroyh� �isn ���lc`= STREET ADDRESS CITY, • STATE, ZIP FAX It) l i g , �: � � c0 0_-J'-�-,-, CONTACT NAME PH2T aa i STREET ADDRESS CITY, STATE, ZIP FAX 13 OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT !LCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ^ LICENSE NUMBER LICENS TYPE BUS. L C # COMPANY 12b? -MAIL *� FAX STREET ADDRESS TY, STATE, ZIP p ARCHITECTIENGNEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP a PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE b` STORIES - USE TYPE .00C. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL - AREA AREA AREA NET AREA BATHROOM - -- KITCHEN OTHER - - REMODEL AREA REMODEL AREA REMODEL AREA ,. PORCH AREA DECK AREA AREA GARAGE AREA: EIDETACH - - 7DFCK/PORCH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES - BENGADDED? []NO ADDITION? ❑NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES$j= _ x TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LE EICHLER HOME? ❑ NO By my signature below, I certify to each of the foll wing: 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 ogre 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 building con rust n. I authorize representatives of Cupertino to enter the abov -identified property for inspection purposes. Signature of Applicant/Agent: Date: -1 Ve f 1 - _ 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. _ Commercial Bldgs; Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. Copy of Planning, Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_201 1. doc revised 06121111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1906 10198 RICHWOOD DR CUPERTINO, CA 95014-3314 (369 08 029) DE ANZA BUILDERS CAMPBELL, CA 95008 OWNER'S NAME: SEETHARAM SHIRISH AND SHIRISH SUSHMA TRUSTE DATE ISSUED: 07/28/2016 OWNER'S PHONE: 408-888-5227 PHONE NO: (408) 865-0222 LICENSED CONTRACTOR'S DFCIARATIQNL BUILDING PERMIT INFO: License Class 13 Lie. #943227 Contractor DE ANZA BUILDERS Date 02/28/2018 X BLDG _ELECT _PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: REMODEL LIVING ROOM, FAMILY ROOM, DINING ROOM AND I hereby affirm under penalty of perjury one of the following two declarations: RELOCATE KITCHEN AND ADD SKYLIGHT 864 SQ FT; ADD (N) L I have and will maintain a certificate of consent to self-insure for Worker's BAY WINDOW AT DINING ROOM; COLUMNS AND GABLE ROOF Compensation, as provided for by Section 3700 of the Labor Code, for the AT ENTRY PORCH; REMOVE FIRE PLACE IN DINING ROOM of the work for which this permit is issued. z�performance 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 Sq. Ft Floor Area: Valuation: $60000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above PN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances 36908 029 369 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 agai t liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against i City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the appl' a understands and will comply with all non-point source regulations p r t e Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 05/11/2017 Issued by: KIM DUNBAR OWNER-BUILDER DECLARATION Date: 07/28/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RF ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) z. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 05/11/2017 1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equip t or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay a it Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cuperti o ifunicipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Aecti s 5505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 05/11/2017 I certify that I have read this application and state that the above information is CONSTRUC ION LE INGAGENCY I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHLY T'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal . 1 understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 05/11/2017 Professional To, City of Cupertino Building Department Please transfer the permit case # B-2016-1906 From - Shirish Seetharam and Sushma Shirish To - Mike Pennington De Anza Builders 645 E. McGlincy Lane Suite D Campbell, CA 95008 408.865.0222 Office 408.499.8391 Mobile Thank You, � L4 a,-- Shirish Seetharam �UW'Lw- AA��J44 Sushma Shirish Dated : 5/11/2017 Dated : 5/11/2017 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1906 10198 RICHWOOD DR CUPERTINO, CA 95014-3314 (369 08 029) OWNER/BUILDER OWNER'S NAME: SEETHARAM SHIRISH AND SHIRISH SUSHMA TRUSTE DATE ISSUED: 07/28/2016 OWNER'S PHONE: 408-777-1223 PHONE NO: LJCENSED CONIRACTOR'S CONTRACTOR'SDECLARATION BUILDING PERMIT INFO: License Class Lic. # Contractor OWNER/BUILDER Date XBLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing _ MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect.. JOB DESCRIPTION: REMODEL LIVING ROOM, FAMILY ROOM, DINING ROOM AND I hereby affirm under penalty of perjury one of the following two declarations: RELOCATE KITCHEN AND ADD SKYLIGHT 864 SQ FT; ADD (N) 1. I have and will maintain a certificate of consent to self -insure for Worker's BAY WINDOW AT DINING ROOM; COLUMNS AND GABLE ROOF Compensation, as provided for by Section 3700 of the Labor Code, for the AT ENTRY PORCH; REMOVE FIRE PLACE IN DINING ROOM performance of the work for which this permit is issued. z 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. Sq. Ft Floor Area: Valuation: $60000.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 369 08 029 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 D AST CALLED INSPECTION. Signature Date 07/28/2016 Issued by: MELISS Date: 07/28/201 OWNER- WILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is i. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection, ,sale (Sec.7044, Business & Professions Code) 2.6-- I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (See.7044, Business & Professions Code). Date: 07/28/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER i. 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. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this , California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. , maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3.'.-' I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous S, air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 505 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall —� be deemed revoked. Owner or authorized agent'; ` APPLICANT CERTIFICATION Date: 07/28/2016 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records, Signatures , ` Date 07/28/2016 Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX {408) 777-3333 - building cllperiintl orct `'J I nl (A 10 niY CUPERTINO F1 NF.W CONCTRT TrTlnm iU Ann7-rrnr.T F7 AT TRD A"n1,T /Tr I� noinarn�t innrnnnnn- PROIECTADDRESS 10198 Richwood Driver Cupertino, 95014 APN4 ''!..( _gi1J 02('y ( OWNERNAME SHIRISH SEETHARAM PHONE4087771223 B -MAIL shirishs@gmaii.com STREETA11111.0198 Richwood Drive. CITY, STATE,ZIPFAX Cu ertino, CA 9501.4 �] CONTACT NA'SUSHM SHIRISH PHONE 4088885227 E-MAIL sushma.shirish@gmail.com /!�1 pp STREHTADDREss10198 Richwood Drive CITY, STATE, Z1P Cu ertino CA 95014 FAX r�r fir+ OWNER ❑. OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LtCENSENUMBER LICENSE TYPE BUS. LIC# COMPANYNAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEERNAME VARSHA NENE LICENSE NUMBER 029857 G U BUS. LIC 4 COMPANYNAME HARMONY ARCHITECTS B -MAIL vnene@yahoo.com FAX STREET ADDRESS 3207 BALMORAL CT CITY,sTATE.zIP PLEASANTON, .CA 945813 PHoNE5107578547 DESCRIPTION OF WORK-- IN-rERIOR-REM-C DEL-0-F-LiVI G FAAfVI LY DDINfING-&-KfT--Cly-EN. NEW BAY WINDOW, NEW COLUMNS & GABLE ROOF AT ENTRY PORCH. EXISTING USE - - PROPOSED USE. CONSTR.TYPE A! STORIES - - RESIDENCE E RESIDENCE VB USE TYPE OCC. SQ.P7'. VALUATION($) AREAEXIST2029 —A2048 NEW LOO EMO AREA TOTAL NET AREA BATHROOM REMODELARRA KITCHEN - REMODEL AREA 194 OTHER n REMODEL AREA .670 s - - - PORCH AREA DECK ARBA TOTAL DECKNORCH AREA GARAOE AREA: [:I DETACH - - 133 I ['I ATTACH I #DWBLLINGUNITS: 1 ISA SECOND UNIT El YES SECONDSTORY QYPS - - - BEINGADDED? �'0 ADDITION? NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS TIIE BLDG AN ❑ YES CEIVED B - TO AL VALUATION: PLANNINGAPPL5 D(NO PLANNING APPROVAL LETTER EICHLERHOME? tC"itNO A ['.e0 By my signature below, I certify to each of the following: I am the property owner or authorized agent to act In 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 wilding construction, I authorize representatives o€Cupertino to enter the above -identified property for inspection purposes. Signature of,Applican—gent: Date: SUPPLEMENTAL INFORMATION REQUIREDPLAN CHECK -TYPE ROUTING SLIP p OVER-THE-COUNTE:R WBUILDING PLAN REVIEW 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. ll E.RPRESSPLANNING PLAN REVIEW Commercial Bldgs: Provide a completed hazardous Materials Disclosure © STANDARD C2' PUBLIC WORKS form if any Hazardous Materials are being used as part ofthis project. I ] LARGE ❑ FIRE DEPT —Copy of Planning Approval Letter or Meeting with Planning prior to 0 MAJOR E) SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEAIJA BldgAplr_2011.doc revised. 06121111 OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 ItPERT[Ni) (408)777-3228 • FAX (408) 777-3333 • buildingOcupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS IDII?, 12\c ti APN _ 2 Q #261 6- M bS OWNER NAME X51-ttRi5w SET P- M OWNERADDRESS I btq%1 RJC_ifVj0 CO340 I DESCRIPTION OF WORK: We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS.: Please read and initial each statement below to signify you understand or verify this information.) I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working bre my property. My, homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of.my insurance coverage for injuries to workers on my property. S' S`2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. S S-3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that 1 may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. G 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. .S `S'5. 1 understand if 'I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 6. 1 understand if I am considered an "employer" under state and federal law; I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �.S • 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. A > 8.1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 011172e7$ui1derFonn 2010.doc revised 04114/10 9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cs[b.ca.gov for more information about licensed contractors. S -S-10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. S 'S 11. l agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. S 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial Foss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:.Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3087 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the. permit is issued to verify the property owner's sig nt re. Property Owner's Signature: , 8 Date:,, Z 21& Od / -------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner -only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OW770BuildelForin 2010.doc revised 04114110 f INNIP1.1 111. STRUCTURAL BULLETIN BULLETIN No: 1 DATE: June 28, 2017 SUBJECT: Footing Rebar and Form PROJECT No: 2839 AWE= * 7.pRES„ R%hod-Dr►v.p nnj CLIENT: Property Owner We have observed the following items for the above project: 1) Footing rebar and form. 2) Epoxy of rebar dowel from new to existing footing. 1707 Guadalupe Ave San Jose, CA 95125 Tel: (415) 269-2880 Email: david@d2sengineer.com 6--,2 o/&lyd6 PAGE 1 of 1 Based on our observation, the work done is in general conformance with our design intent. This is a general conformance inspection and not every dimension and placement is verified in detail. All inspections performed were based on visible framing at the time of the engineer's visit and hidden framing not accessible to the engineer at the time of visit were not verified. Please call me if you should have any questions. Sincerely, Davi"uang Principal STRUCTURAL BULLETIN BULLETIN No- 2 DATE. July 3, 2017 SUBJECT Field Revision PROJECT No- 2839 PROJECT ADDRESS, 10198 Richwood Drive, Cupertino, CA CLIENT Property Owner MEMO 1707 Guadalupe Ave San Jose, CA 95125 Tel: (415) 269-2880 Email: david@d2sengineer.com PAGE 1 of 3 It is structurally acceptable to use the attached plan cut sheets in place of the approved set of plan of the same locations. Location of support posts are moved to reflect architectural requirements. All other elements of the approved plans remain unchanged. Please call me if you should have any questions Sincerely, Davi 'fang Principal CUPERTINO Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By- Phuong Devries Date- 07/26/17 -x'0110'19 Udo STATE OF CALIFORNIA DUCT LEAKAGE DIAGNOSTIC TEST CEC-CF3R-MCH-20-H(Revised-12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3) ProjectName: E fprcemen a ry: Permit Number: Sustwta and Shirish Seetharawt arty orcrupertivto 132o16-2906 Dwelling Address: City Zip Code 2019 s Richwood Drive Cupertino 9 5014 A.System Information 01 Space Conditioning System Identification or Name 02 Space Conditioning System Location or Area Served 03 Building Type from CF1R 04 Verified Low Leakage Ducts in Conditioned Space(VLLDCS)Credit from CF1R? 05 Verified Low Leakage Air-handling Unit Credit from CF1R? 06 Duct System Compliance Category MCH-20d-Complete Replacement or Altered Duct System B.Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity(ton) 02 Heating Capacity(kBtu/h) 03 Conditioned Floor Area Served by this HVAC System(ft2) 04 Duct Leakage Test Conditions 05 Duct Leakage Test Method? • 06 Leakage Factor 07 Air-Handler Unit Airflow(AHU Airflow)Determination Method 08 Measured AHU Airflow(cfm) 09 Calculated Target Allowable Duct Leakage Rate(cfm) 10 Actual duct leakage rate from leakage test measurement(cfm) 11 Compliance statement: Existivtg ducts have asbestos and cannot be tested. 12 Notes: C.Additional Requirements for Compliance 01 System was tested in its normal operation condition: No temporary taping allowed. Outside air(OA)duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage testing.OA ducts 02 used for Central Fan Integrated(CFI)Indoor Air Quality ventilation systems,or Central Fan Ventilation Cooling Systems,that utilize dampers that open only when OA is required and automatically close when OA is not required,may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement,all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. . 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. 07 If the system complies using the Smoke Test method,the smoke test was conducted in accordance with the requirements of Reference • ' Residential Appendix RA-3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS verification. 08 Verification Status: 09 Correction Notes: The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards-2013 Residential Compliance December 2015 t STATE OF CALIFORNIA DUCT LEAKAGE DIAGNOSTIC TEST CEC-CF3R-MCH-20-H(Revised 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) Proe Name: E fprcemen a cy: Permit Number: Sus testa and Slnirisln Seetlnarawi. �lty o G�apertivto 732016-1906 Dwelling Address: City Zip Code 1019 S Richwood Drive Cupertino 95024 D.Determination of HERS Verification Compliance All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 01 Existing ducts leave asbestos wrap and are excewtpt fromtesting pursuant to Subsection i-41.0(b)2Pii or Subsection 141.0(b)2Eii. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards-2013 Residential Compliance December 2015 BUILDING ENERGY ANALYSIS REPORT PROJECT: Project Designer: Report Prepared by: Job Number: Date: The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2013 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC www.energysoft.com. 3207 Balmoral Ct Varsha Nene Pleasanton, CA 94588 510-757-8547 10198 Richwood Dr Shirish Seetharam & Sushma Shirish Cupertino, CA 95014 PO Box 3777 NRG Compliance, Inc Rick Rocklewitz Santa Rosa, California 95402 707-237-6957 080415 8/4/2015 ID: 080415 EnergyPro 6.6 by EnergySoft User Number: 5581 Phuong Devries 07/15/16 Job Number: TABLE OF CONTENTS Form MF-1R Mandatory Measures Summary Cover Page Table of Contents Form CF-1R-PRF-01-E Certificate of Compliance Form RMS-1 Residential Measures Summary 12 1 2 3 11 ID: 080415 EnergyPro 6.6 by EnergySoft User Number: 5581 Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 1of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ GENERALINFORMATION 01 Project Name Residential Building 02 CalculationDescription Title24Analysis 03 Project Location 10198RichwoodDr 04 City Cupertino 05 StandardsVersion Compliance2015 06 ZipCode 95014 07 ComplianceManagerVersion BEMCmpMgr 2013-4(744) 08 ClimateZone CZ4 09 SoftwareVersion EnergyPro6.6 10 BuildingType SingleFamily 11 Front Orientation(deg/Cardinal) 315 12 Project Scope Additionand/or Alteration 13 Numberof DwellingUnits 1 14 Total Cond. FloorArea(ft2) 2048 15 Numberof Zones 2 16 SlabArea(ft2) 0 17 Numberof Stories 1 18 AdditionCond. FloorArea 19 19 Natural Gas Available Yes 20 AdditionSlabArea(ft2) 0 21 GlazingPercentage(%) 18.3% COMPLIANCERESULTS 01 BuildingComplieswithComputerPerformance 02 ThisbuildingDOESNOTrequireHERSVerification 03 ThisbuildingincorporatesoneormoreSpecial Featuresshownbelow ENERGYUSESUMMARY 04 05 06 07 08 EnergyUse(kTDV/ft2-yr) StandardDesign ProposedDesign ComplianceMargin Percent Improvement SpaceHeating 44.39 41.67 2.72 6.1% SpaceCooling 43.24 45.66 -2.42 -5.6% IAQVentilation 0.00 0.00 0.00 0.0% WaterHeating 14.44 14.44 0.00 0.0% PhotovoltaicOffset ---- 0.00 0.00 ----ComplianceEnergyTotal 102.07 101.77 0.30 0.3% Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 2of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ REQUIREDSPECIALFEATURES Thefollowingare featuresthat must beinstalledas conditionfor meetingthemodeledenergyperformancefor thiscomputer analysis. Cathedral Ceiling HERSFEATURESUMMARY Thefollowingisasummaryof the featuresthat must befield-verifiedbyacertifiedHERSRater asa conditionfor meetingthemodeledenergyperformancefor thiscomputer analysis. Additional detail is provided inthebuildingcomponentstablesbelow. Building-level Verifications: -- None--CoolingSystemVerifications: -- None--HVACDistributionSystemVerifications: -- None--DomesticHot WaterSystemVerifications: -- None--ENERGYDESIGNRATING Thisisthesumof theannual TDVenergyconsumptionfor energyusecomponentsincludedintheperformancecomplianceapproachfor theStandardDesignBuilding(EnergyBudget) andtheannual TDVenergyconsumptionfor lightingandcomponentsnot regulatedbyTitle24, Part 6(suchasdomesticappliancesandconsumer electronics) andaccountingfor theannual TDVenergyoffset byan on-siterenewableenergysystem. ReferenceEnergyUse EnergyDesignRating Margin Percent Improvement Total Energy(kTDV/f2-yr)* 151.13 150.83 0.30 0.2% *includescalculatedAppliancesandMiscellaneousEnergyUse(AMEU) BUILDING-FEATURESINFORMATION 01 02 03 04 05 06 07 Project Name ConditionedFloorArea(ft2) Numberof Dwelling Units Numberof Bedrooms Numberof Zones Numberof Ventilation CoolingSystems Numberof Water Heating Systems Residential Building 2048 1 4 2 0 1 ZONEINFORMATION 01 02 03 04 05 06 07 ZoneName ZoneType HVACSystemName ZoneFloorArea (ft2) Avg. Ceiling Height WaterHeatingSystem1 WaterHeatingSystem2 First Floor Conditioned HVACSystem1 19 8 DHWSys1 First Floor (Existing) Conditioned HVACSystem1 2029 8 DHWSys1 Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 3of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ OPAQUESURFACES 01 02 03 04 05 06 07 08 09 10 Name Zone Construction Azimuth Orientation GrossArea(ft2) Window& Door Area (ft2) Tilt (deg) Status Verified Existing Condition Northeast Wall First Floor R-13Wall 45 Left 20 6 90 New N/A Southeast Wall First Floor R-13Wall 135 Back 62 24 90 New N/A Southwest Wall First Floor R-13Wall 225 Right 20 6 90 New N/A Roof 2 First Floor R-19Roof Attic 19 New N/A RaisedFloor First Floor R-19Floor Crawlspace 19 New N/A Northwest Wall First Floor (Existing) Default Wall Prior to197 315 Front 276 68 90 Existing No Northeast Wall 2 First Floor (Existing) Default Wall Prior to197 45 Left 428 65.5 90 Existing No Southeast Wall 2 First Floor (Existing) Default Wall Prior to197 135 Back 380.6 116 90 Existing No Southwest Wall 2 First Floor (Existing) Default Wall Prior to197 225 Right 427.3 106.3 90 Existing No Interior SurfaceWall First Floor (Existing)>>__Garage__ Default Wall Prior to1971 166.6 20 Existing No Roof 3 First Floor (Existing) Default Roof Prior to197 2025 Existing No RaisedFloor 2 First Floor (Existing) Default Floor Crawlspace 2029 Existing No Northwest Wall 2 __Garage__ R-0Wall 315 Front 166.6 90 Existing No Northeast Wall 3 __Garage__ R-0Wall 45 Left 170 90 Existing No Southwest Wall 3 __Garage__ R-0Wall 225 Right 171 90 Existing No Roof 4 __Garage__ R-0Roof Attic 446 Existing No OPAQUESURFACESCathedral Ceilings 01 02 03 04 05 06 07 08 09 10 11 12 13 Name Zone Type Orientatio n Area (ft2) Skylight Area(ft2) Roof Rise (xin12) Roof Pitch Roof Tilt(deg) Roof Reflectan ce Roof Emittance Framin g Factor Statu s Verified Existing Condifion Roof First Floor (Existing) Default Roof Prior to1971 Front 4.1 4 4 0.33 18.43 0.1 0.85 0.1 Existin g No Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 4of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ ATTIC 01 02 03 04 05 06 07 08 09 10 Name Construction Type Roof Rise Roof Reflectance Roof Emittance Radiant Barrier Cool Roof Statu s VerifiedExisting Condition AtticGarage AtticGarageRoof Cons Ventilated 4 0.1 0.85 No No Existi ng No AtticFirst Floor AtticRoofFirst Floor Ventilated 4 0.1 0.85 No No New No AtticFirst Floor (Existing) AtticRoofFirst Floor (Existing) Ventilated 4 0.1 0.85 No No Existi ng No WINDOWS 01 02 03 04 05 06 07 08 09 10 11 Name Surface(Orientation-Azimuth) Width(ft) Height (ft) Multiplie r Area(ft2) U-factor SHGC ExteriorShading Status Verified Existing Condition Window Northeast Wall (Left-45) ---- ---- 1 6.0 0.34 0.34 Insect Screen(default) New N/A Window2 Southeast Wall (Back-135) ---- ---- 1 24.0 0.34 0.34 Insect Screen(default) New N/A Window3 Southwest Wall (Right-225) ---- ---- 1 6.0 0.34 0.34 Insect Screen(default) New N/A Window4 Northwest Wall (Front-315) ---- ---- 1 48.0 0.58 0.65 Insect Screen(default) Existing No Window5 Northeast Wall 2(Left-45) ---- ---- 1 65.5 0.58 0.65 Insect Screen(default) Existing No Window6 Southeast Wall 2(Back-135) ---- ---- 1 56.0 0.58 0.65 Insect Screen(default) Existing No Window(New) Southeast Wall 2(Back-135) ---- ---- 1 60.0 0.34 0.34 Insect Screen(default) New N/A Window7 Southwest Wall 2(Right-225) ---- ---- 1 88.0 0.58 0.65 Insect Screen(default) Existing No Window(New) 2 Southwest Wall 2(Right-225) ---- ---- 1 18.3 0.34 0.34 Insect Screen(default) New N/A Skylight (New) Roof (Front-315) ---- ---- 1 4.0 0.39 0.29 None New N/A DOORS 01 02 03 04 05 06 Name Sideof Building Area(ft2) U-factor Status VerifiedExistingCondition Door Northwest Wall 20.0 0.50 Existing No Door (New) Interior SurfaceWall 20.0 0.50 New No Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 5of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ OPAQUESURFACECONSTRUCTIONS 01 02 03 04 05 06 07 ConstructionName SurfaceType ConstructionType Framing Total Cavity R-value WinterDesign U-value AssemblyLayers R-0Wall Exterior Walls WoodFramedWall 2x4@16in. O.C. none 0.302 InsideFinish: GypsumBoard Cavity/ Frame: noinsul. /2x4 Exterior Finish: Wood Siding/sheathing/decking R-0Roof Attic Ceilings(below attic) WoodFramedCeiling 2x4@24in. O.C. none 0.481 InsideFinish: GypsumBoard Cavity/ Frame: noinsul. /2x4 AtticGarageRoof Cons AtticRoofs WoodFramedCeiling 2x4TopChordof Roof Truss@24 in. O.C. none 0.644 Cavity/ Frame: noinsul. /2x4TopChrd Roof Deck: WoodSiding/sheathing/decking Roofing: Light Roof (Asphalt Shingle) AtticRoofFirst Floor AtticRoofs WoodFramedCeiling 2x4TopChordof Roof Truss@24 in. O.C. none 0.644 Cavity/ Frame: noinsul. /2x4TopChrd Roof Deck: WoodSiding/sheathing/decking Roofing: Light Roof (Asphalt Shingle) R-19Floor Crawlspace FloorsOver Crawlspace WoodFramedFloor 2x6@16in. O.C. R19 0.049 Floor Surface: Carpeted Floor Deck: WoodSiding/sheathing/decking Cavity/ Frame: R-19/2x6 R-13Wall Exterior Walls WoodFramedWall 2x4@16in. O.C. R13 0.095 InsideFinish: GypsumBoard Cavity/ Frame: R-13/2x4 Exterior Finish: Wood Siding/sheathing/decking R-19Roof Attic Ceilings(below attic) WoodFramedCeiling 2x4@24in. O.C. R19 0.049 InsideFinish: GypsumBoard Cavity/ Frame: R-9.1/2x4 Over Floor Joists: R-9.9insul. AtticRoofFirst Floor (Existing) AtticRoofs WoodFramedCeiling 2x4TopChordof Roof Truss@24 in. O.C. none 0.644 Cavity/ Frame: noinsul. /2x4TopChrd Roof Deck: WoodSiding/sheathing/decking Roofing: Light Roof (Asphalt Shingle) Default Floor Crawlspace FloorsOver Crawlspace WoodFramedFloor 2x12@16in. O.C. none 0.216 Floor Surface: Carpeted Floor Deck: WoodSiding/sheathing/decking Cavity/ Frame: noinsul. /2x12 Default Wall Prior to197 Exterior Walls WoodFramedWall 2x4@16in. O.C. none 0.302 InsideFinish: GypsumBoard Cavity/ Frame: noinsul. /2x4 Exterior Finish: Wood Siding/sheathing/decking Default Roof Prior to197 Ceilings(below attic) WoodFramedCeiling 2x4@16in. O.C. R11 0.083 InsideFinish: GypsumBoard Cavity/ Frame: R-9.1/2x4 Over Floor Joists: R-1.9insul. Default Roof Prior to1971 Cathedral Ceilings WoodFramedCeiling 2x4@16in. O.C. R11 0.088 InsideFinish: GypsumBoard Cavity/ Frame: R-11/2x4 Roof Deck: WoodSiding/sheathing/decking Roofing: Light Roof (Asphalt Shingle) Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 6of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ Default Wall Prior to1971 Interior Walls WoodFramedWall 2x4@16in. O.C. none 0.277 InsideFinish: GypsumBoard Cavity/ Frame: noinsul. /2x4 Other SideFinish: GypsumBoard WATER HEATING SYSTEMS 01 02 03 04 05 06 07 08 Name SystemType DistributionType WaterHeater Numberof Heaters Solar Fraction (%) Status VerifiedExisting Condition DHWSys1 DHW Standard DHWHeater 1 1 Annual Existing No WATER HEATERS 01 02 03 04 05 06 07 08 Name HeaterElement Type TankType TankVolume (gal) EnergyFactoror Efficiency Input Rating TankExterior InsulationR-value StandbyLoss (Fraction) DHWHeater 1 Natural Gas Small Storage 50 0.575EF 40000-Btu/hr 0 0 WATER HEATING-HERSVERIFICATION 01 02 03 04 05 06 07 Name PipeInsulation Parallel Piping Compact Distribution Point-of Use Recirculationwith Manual Control Recirculationwith SensorControl DHWSys1 n/a n/a n/a n/a n/a n/a SPACECONDITIONINGSYSTEMS 01 02 03 04 05 06 07 08 09 HeatingSystem CoolingSystem Name SystemType Name Ducted Name Ducted Distribution System Fan System FloorArea Served Status VerifiedExisting Condition HVACSystem1 Other Heatingand CoolingSystem Heating Component 1 Yes Cooling Component 1 Yes Air Distribution System1 HVACFan 1 2048 Existing No HVAC - HEATINGSYSTEMS 01 02 03 Name Type Efficiency HeatingComponent 1 CntrlFurnace-Fuel-firedcentral furnace 78AFUE Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 7of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ HVAC-COOLINGSYSTEMS 01 02 03 04 05 06 07 Efficiency ZonallyControlled Multi-speed Compressor Name SystemType EER SEER HERSVerification CoolingComponent 1 SplitAirCond- Split air conditioning system 9.6 11 No No N/A HVAC- DISTRIBUTIONSYSTEMS 01 02 03 04 05 06 07 08 09 10 Name Type Duct Leakage Insulation R-value SupplyDuct Location ReturnDuct Location BypassDuct Status Verified Existing Condition HERS Verification Air Distribution System1 Ductslocatedinattic Existing(not specified) 4.2 Attic Attic None Existing No N/A HVACDISTRIBUTION- HERSVERIFICATION 01 02 03 04 05 06 Duct Leakage Duct Leakage VerifiedDuct Design Name Verification Target (%) VerifiedDuct Location Return Supply Air DistributionSystem1-hers-dist N/A --- --- --- ---IAQ(IndoorAirQuality) FANS01 02 03 04 05 Name IAQCFM IAQFanType IAQRecoveryEffectiveness(%) HERSVerification SFamIAQVentRpt 0 Default 0 Not Required Phuong Devries 07/15/16 CERTIFICATEOFCOMPLIANCE-RESIDENTIALPERFORMANCECOMPLIANCEMETHOD CF1R-PRF-01 Project Name: Residential Building CalculationDate/Time: 07:52, Tue, Aug04, 2015 Page 8of 8 CalculationDescription: Title24Analysis Input FileName: seetharam&shirishaddition.xml ߰!"#$ % %& ߰'# ߰"(")!"#*߰(++ %,-!"#*߰")߰"+"(*+"+ DOCUMENTATIONAUTHOR'SDECLARATIONSTATEMENT 1. I certifythat thisCertificateof Compliance documentationisaccurateandcomplete. DocumentationAuthor Name: DocumentationAuthor Signature: Company: SignatureDate: Address: CEA/HERSCertificationIdentification(If applicable): City/State/Zip: Phone: RESPONSIBLEPERSON'SDECLARATIONSTATEMENT I certifythefollowingunder penaltyof perjury, under thelawsof theStateof California: 1. I ameligibleunder Division3of theBusinessandProfessionsCodetoaccept responsibilityfor thebuildingdesign identifiedonthisCertificateof Compliance. 2. I certifythat theenergyfeaturesandperformancespecificationsidentifiedonthisCertificateof Complianceconformtotherequirementsof Title24, Part 1andPart 6of theCaliforniaCodeof Regulations. 3. Thebuildingdesignfeaturesor systemdesignfeaturesidentifiedonthisCertificateof Complianceareconsistent withtheinformationprovidedonother applicablecompliancedocuments, worksheets, calculations, plansandspecificationssubmittedtotheenforcement agencyfor approval withthisbuildingpermit application. ResponsibleDesigner Name: ResponsibleDesigner Signature: Company: DateSigned: Address: License: City/State/Zip: Phone: Rick Rocklewitz NRG Compliance, Inc PO Box 3777 Santa Rosa, California 95402 707-237-6957 8/4/2015 Varsha Nene Varsha Nene 3207 Balmoral Ct Pleasanton, CA 94588 510-757-8547 8-4-15 C29857 Phuong Devries 07/15/16 RESIDENTIAL MEASURES SUMMARY RMS-1 Project Name Building Type o Single Family o Addition Alone Date o Multi Family o Existing+ Addition/Alteration Project Address California Energy Climate Zone Total Cond. Floor Area Addition # of Units INSULATION Area Construction Type Cavity (ft2) Special Features Status FENESTRATION Total Area: Glazing Percentage: New/Altered Average U-Factor: Orientation Area(ft2) U-Fac SHGC Overhang Sidefins Exterior Shades Status HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status HVAC DISTRIBUTION Duct Location Heating Cooling Duct Location R-Value Status WATER HEATING Qty. Type Gallons Min. Eff Distribution Status Shirish Seetharam & Sushma Shirish 10198 Richwood Dr Cupertino 0.65 Wood Framed 8/4/2015 ✔ ✔ CA Climate Zone 04 2,048 1 Wood Framed Attic Floor Wall Roof Floor Wall Door Wood Framed w/Crawl Space Wood Framed Wood Framed w/Crawl Space Opaque Door 19 66 19 2,029 1,303 20 - no insulation - R 19 R 13 R 19 - no insulation - - no insulation - Existing New New New Existing Existing 19 Left (NE) Rear (SE) Right (SW) Front (NW) Left (NE) Rear (SE) Right (SW) Skylight 88.0 6.0 84.0 24.3 48.0 65.5 56.0 4.0 0.580 0.580 0.340 0.340 0.340 0.580 0.580 0.390 0.65 0.34 0.34 0.34 0.65 0.65 0.29 none none none none none none none none none none none none none none none none Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen Bug Screen None Existing Existing New New New Existing Existing New 11.0 SEER 1 Central Furnace Split Air Conditioner 78% AFUE Existing Setback AtticHVAC System Ducted Ducted Existing 4.2 ID: 080415 Page 11 of 15 EnergyPro 6.6 by EnergySoft User Number: 5581 RunCode: 2015-08-04T07:54:44 Wood Framed Attic Roof Demising Wood Framed 2,025 11 R 11 - no insulation - Existing Existing 376 18.3 % 0.34 Phuong Devries 07/15/16 2013 Low-Rise Residential Mandatory Measures Summary NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. Exceptions may apply. Review the respective code section for more information. Building Envelope Measures: §110.6(a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §110.6(a)5:Fenestration products (except field-fabricated windows) have a label listing the certified U-Factor, certified Solar Heat Gain Coefficient (SHGC), and infiltration that meets the requirements of §10-111(a). §110.7: Exterior doors and windows are weatherstripped; all joints and penetrations are caulked and sealed. §110.8(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on the CF2R. §110.8(i):The thermal emittance and aged solar reflectance values of the cool roofing material meets the requirements of §110.8(i) when the installation of a cool roof is specified on the CF1R. §110.8(j): A radiant barrier shall have an emittance of 0.05 or less when the installation of a radiant barrier is specified on the CF1R. §150.0(a): Minimum R-30 insulation in wood-frame ceiling; or the weighted average U-factor shall not exceed 0.031. Minimum R-19 in a rafter roof alteration. Attic access doors shall have permanently attached insulation using adhesive or mechanical fasteners. The attic access shall be gasketed to prevent air leakage. §150.0(b): Loose fill insulation shall conform with manufacturers installed design labeled R-value. §150.0(c):Minimum R-13 insulation in 2x4 inch wood framing wall or have a U-factor of 0.102 or less (R-19 in 2x6 or 0.074 maximum U- factor). §150.0(d): Minimum R-19 insulation in raised wood-frame floor or 0.037 maximum U-factor. §150.0(g)1: In Climate Zones 14 and 16 a Class II vapor retarder shall be installed on the conditioned space side of all insulation in all exterior walls, vented attics and unvented attics with air-permeable insulation. §150.0(g)2: In Climate Zones 1-16 with unvented crawl spaces the earth floor of the crawl space shall be covered with a Class I or Class II vapor retarder. §150.0(g)3: In a building having a controlled ventilation crawl space, a Class I or Class II vapor retarder shall be placed over the earth floor of the crawl space to reduce moisture entry and protect insulation from condensation, as specified in the exception to Section 150.0(d). §150.0(l):Slab edge insulation shall: have a water absorption rate, for the insulation material alone without facings, no greater than 0.3%; have water vapor permeance rate is no greater than 2.0 perm/inch, be protected from physical damage and UV light deterioration; and when installed as part of a heated slab floor meets the requirements of §110.8(g). §150.0(q):Fenestration, including skylights, separating conditioned space from unconditioned space or outdoors shall have a maximum U- factor of 0.58; or the weighted average U-factor of all fenestration shall not exceed 0.58. Fireplaces, Decorative Gas Appliances and Gas Log Measures: §150.0(e)1A: Masonry or factory-built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150.0(e)1B:Masonry or factory-built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a readily accessible, operable, and tight-fitting damper or a combustion-air control device. §150.0(e)1C: Masonry or factory-built fireplaces have a flue damper with a readily accessible control. §150.0(e)2:Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: §110.0-§110.3: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified to the Energy Commission. §110.3(c)5:Water heating recirculation loops serving multiple dwelling units meet the air release valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of §110.3(c)5. §110.5: Continuously burning pilot lights are prohibited for natural gas: fan-type central furnaces, household cooking appliances (appli- ances without an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and spa heaters. §150.0(h)1:Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA using design conditions specified in §150.0(h)2. §150.0(h)3A:Installed air conditioner and heat pump outdoor condensing units shall have a clearance of at least five feet from the outlet of any dryer vent. §150.0(i): Heating systems are equipped with thermostats that meet the setback requirements of §110.2(c). §150.0(j)1A:Storage gas water heaters with an energy factor equal to or less than the federal minimum standards shall be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §150.0(j)1B:Unfired hot water tanks, such as storage tanks and backup storage tanks for solar water-heating systems, have R-12 external insulation or R-16 internal insulation where the internal insulation R-value is indicated on the exterior of the tank. §150.0(j)2A: For domestic hot water system piping, whether buried or unburied: the first 5 feet of hot and cold water pipes from the storage tank, all piping with a nominal diameter of 3/4 inch or larger, all piping associated with a domestic hot water recirculation system regardless of the pipe diameter, piping from the heating source to storage tank or between tanks, piping buried below grade, and all hot water pipes from the heating source to kitchen fixtures must be insulated according to the requirements of TABLE 120.3- A. §150.0(j)2B:All domestic hot water pipes that are buried below grade must be installed in a water proof and non-crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. Phuong Devries 07/15/16 2013 Low-Rise Residential Mandatory Measures Summary §150.0(j)2C:Pipe for cooling system lines shall be insulated as specified in §150.0(j)2A. Piping insulation for steam and hydronic heating systems or hot water systems with pressure > 15 psig shall meet the requirements in TABLE 120.3-A. §150.0(j)3: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. §150.0(j)3A: Insulation exposed to weather shall either be rated for outdoor use or installed with a cover suitable for outdoor service. For example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation protected as specified or painted with coating that is water retardant and provides shielding from solar radiation that degrades the material. §150.0(j)3B: Insulation covering chilled water piping and refrigerant suction piping located outside the conditioned space shall have a Class I or Class II vapor retarding facing, or the insulation shall be installed at the thickness that qualifies as a Class I or Class II vapor retarder. §150.0(n)1: Systems using gas or propane water heaters to serve individual dwelling units shall include: a 120V electrical receptacle within 3 feet of the water heater; a Category III or IV vent, or a Type B vent with straight pipe between the outside termination and the space where the water heater is installed; a condensate drain that is no more than 2 inches higher than the base of the installed water heater, and allows natural draining without pump assistance; and a gas supply line with a capacity of at least 200,000 Btu/hr. §150.0(n)2: Recirculating loops serving multiple dwelling units shall meet the requirements of §110.3(c)5. §150.0(n)3:Solar water-heating systems and collectors shall be certified and rated by the Solar Rating and Certification Corporation (SRCC) or by a testing agency approved by the Executive Director. Ducts and Fans Measures: §150.0(m)1: All air-distribution system ducts and plenums installed are sealed and insulated to meet the requirements of CMC §601.0, §602.0, §603.0, §604.0, §605.0 and ANSI/SMACNA-006-2006 HVAC Duct Construction Standards Metal and Flexible 3rd Edition. Supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-6.0 (or higher if required by CMC §605.0) or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing (RA3.1.4.3.8). Connections of metal ducts and inner core of flexible ducts are mechanically fastened. Openings shall be sealed with mastic, tape, or other duct-closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than ¼ inch, the combination of mastic and either mesh or tape shall be used. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150.0(m)2: Factory-Fabricated Duct Systems shall comply with specified requirements for duct construction, connections, and closures; joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. §150.0(m)3-6:Field-Fabricated Duct Systems shall comply with requirements for: pressure-sensitive tapes, mastics, sealants, and other requirements specified for duct construction; duct insulation R-value ratings; duct insulation thickness; and duct labeling. §150.0(m)7:All fan systems that exchange air between the conditioned space and the outside of the building must have backdraft or automatic dampers. §150.0(m)8:Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers except combustion inlet and outlet air openings and elevator shaft vents. §150.0(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind but not limited to the following: insulation exposed to weather shall be suitable for outdoor service. For example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation. §150.0(m)10: Flexible ducts cannot have porous inner cores. §150.0(m)11: When space conditioning systems use forced air duct systems to supply conditioned air to an occupiable space, the ducts shall be sealed and duct leakage tested, as confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. §150.0(m)12: Mechanical systems that supply air to an occupiable space through ductwork exceeding 10 feet in length and through a thermal conditioning component, except evaporative coolers, shall be provided with air filter devices that meet the requirements of §150.0(m)12. §150.0(m)13: Space conditioning systems that utilize forced air ducts to supply cooling to an occupiable space shall have a hole for the placement of a static pressure probe (HSPP), or a permanently installed static pressure probe (PSPP) in the supply plenum. The space conditioning system must also demonstrate airflow ≥ 350 CFM per ton of nominal cooling capacity through the return grilles, and an air-handling unit fan efficacy ≤ 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. §150.0(m)15: Zonally controlled central forced air cooling systems shall be capable of simultaneously delivering, in every zonal control mode, an airflow from the dwelling, through the air handler fan and delivered to the dwelling, of ≥ 350 CFM per ton of nominal cooling capacity, and operating at an air-handling unit fan efficacy of ≤ 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. §150.0(o): All dwelling units shall meet the requirements of ASHRAE Standard 62.2. Neither window operation nor continuous operation of central forced air system air handlers used in central fan integrated ventilation systems are permissible methods of providing the Whole Building Ventilation. §150.0(o)1A:Whole Building Ventilation airflow shall be confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Pool and Spa Heating Systems and Equipment Measures: §110.4(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations; an on-off switch mounted outside of the heater that allows shutting off the heater without adjusting the thermostat setting; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating. Phuong Devries 07/15/16 2013 Low-Rise Residential Mandatory Measures Summary §110.4(b)1:Any pool or spa heating equipment shall be installed with at least 36 inches of pipe between filter and heater or dedicated suction and return lines, or built-up connections for future solar heating. §110.4(b)2: Outdoor pools or spas that have a heat pump or gas heater shall have a cover. §110.4(b)3:Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or pro- grammed to run only during off-peak electric demand periods. §110.5: Natural gas pool and spa heaters shall not have a continuous burning pilot light. §150.0(p): Residential pool systems or equipment shall meet specified pump sizing, flow rate, piping, filters, and valve requirements. Lighting Measures: §110.9: All lighting control devices and systems, ballasts, and luminaires shall meet the applicable requirements of §110.9. §150.0(k)1A:Installed luminaires shall be classified as high-efficacy or low-efficacy for compliance with §150.0(k) in accordance with TABLE 150.0-A or TABLE 150.0-B, as applicable. §150.0(k)1B:When a high efficacy and low efficacy lighting system are combined in a single luminaire, each system shall separately comply with the applicable provisions of §150.0(k). §150.0(k)1C: The wattage and classification of permanently installed luminaires in residential kitchens shall be determined in accordance with §130.0(c). In residential kitchens, the wattage of electrical boxes finished with a blank cover or where no electrical equipment has been installed, and where the electrical box can be used for a luminaire or a surface mounted ceiling fan, shall be calculated as 180 watts of low efficacy lighting per electrical box. §150.0(k)1D: Ballasts for fluorescent lamps rated 13 watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150.0(k)1E: Permanently installed night lights and night lights integral to installed luminaires or exhaust fans shall be rated to consume no more than 5 watts of power per luminaire or exhaust fan as determined in accordance with §130.0(c). Night lights do not need to be controlled by vacancy sensors. §150.0(k)1F:Lighting integral to exhaust fans (except when installed by the manufacturer in kitchen exhaust hoods) shall meet the applicable requirements of §150.0(k). §150.0(k)2A: High efficacy luminaires must be switched separately from low efficacy luminaires. §150.0(k)2B: Exhaust fans shall be switched separately from lighting systems. §150.0(k)2C: Luminaires shall be switched with readily accessible controls that permit the luminaires to be manually switched ON and OFF. §150.0(k)2D: Controls and equipment are installed in accordance with manufacturers instructions. §150.0(k)2E: No control shall bypass a dimmer or vacancy sensor function if the control is installed to comply with §150.0(k). §150.0(k)2F: Lighting controls comply with applicable requirements of §110.9. §150.0(k)2G: An Energy Management Control System (EMCS) may be used to comply with dimmer requirements if: it functions as a dimmer according to §110.9; meets Installation Certificate requirements of §130.4; the EMCS requirements of §130.5; and all other requirements in §150.0(k)2. §150.0(k)2H: An Energy Management Control System (EMCS) may be used to comply with vacancy sensor requirements of §150.0(k) if: it functions as a vacancy sensor according to §110.9; meets Installation Certificate requirements of §130.4; the EMCS requirements of §130.5; and all other requirements in §150.0(k)2. §150.0(k)2I:A multiscene programmable controller may be used to comply with dimmer requirements of this section if it provides the functionality of a dimmer according to §110.9, and complies with all other applicable requirements in §150.0(k)2. §150.0(k)3A: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. §150.0(k)3B: Kitchen lighting includes all permanently installed lighting in the kitchen except internal lighting in cabinets that illuminate only the inside of the cabinets. Lighting in areas adjacent to the kitchen, including but not limited to dining and nook areas, are considered kitchen lighting if they are not separately switched from kitchen lighting. §150.0(k)4:Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. §150.0(k)5: A minimum of one high efficacy luminaire shall be installed in each bathroom; and all other lighting installed in each bathroom shall be high efficacy or controlled by vacancy sensors. §150.0(k)6:Lighting installed in attached and detached garages, laundry rooms, and utility rooms shall be high efficacy luminaires and controlled by vacancy sensors. §150.0(k)7:Lighting installed in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, and utility rooms shall be high efficacy, or shall be controlled by either dimmers or vacancy sensors. §150.0(k)8: Luminaires recessed into ceilings shall: be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; have a label that certifies that the luminaire is airtight with air leakage less than 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; be sealed with a gasket or caulk between the luminaire housing and ceiling, and shall have all air leak paths between conditioned and unconditioned spaces sealed with a gasket or caulk; and allow ballast maintenance and replacement without requiring cutting holes in the ceiling. For recessed compact fluorescent luminaries with ballasts to qualify as high efficacy for compliance with §150.0(k), the ballasts shall be certified to the Energy Commission to comply with the applicable requirements in §110.9. §150.0(k)9A: For single-family residential buildings, outdoor lighting permanently mounted to a residential building or other buildings on the same lot shall be high efficacy, or may be low efficacy if it meets all of the following requirements: i. Controlled by a manual ON and OFF switch that does not override to ON the automatic actions of Items ii or iii below; and ii. Controlled by a motion sensor not having an override or bypass switch that disables the motion sensor, or controlled by a motion sensor having a temporary override switch which temporarily bypasses the motion sensing function and automatically reactivates the motion sensor within 6 hours; and iii. Controlled by one of the following methods:Phuong Devries 07/15/16 2013 Low-Rise Residential Mandatory Measures Summary a. Photocontrol not having an override or bypass switch that disables the photocontrol; or b. Astronomical time clock not having an override or bypass switch that disables the astronomical time clock, and which is programmed to automatically turn the outdoor lighting OFF during daylight hours; or c. Energy management control system which meets all of the following requirements: At a minimum provides the functionality of an astronomical time clock in accordance with §110.9; meets the Installation Certification requirements in §130.4; meets the requirements for an EMCS in §130.5; does not have an override or bypass switch that allows the luminaire to be always ON; and, is programmed to automatically turn the outdoor lighting OFF during daylight hours. §150.0(k)9B: For low-rise multifamily residential buildings, outdoor lighting for private patios, entrances, balconies, and porches; and outdoor lighting for residential parking lots and residential carports with less than eight vehicles per site shall comply with one of the following requirements: i. Shall comply with §150.0(k)9A; or ii. Shall comply with the applicable requirements in §110.9, §130.0, §130.2, §130.4, §140.7 and §141.0. §150.0(k)9C:For low-rise residential buildings with four or more dwelling units, outdoor lighting not regulated by §150.0(k)9B or 150.0(k)9D shall comply with the applicable requirements in §110.9, §130.0, §130.2, §130.4, §140.7 and §141.0. §150.0(k)9D:Outdoor lighting for residential parking lots and residential carports with a total of eight or more vehicles per site shall comply with the applicable requirements in §110.9, §130.0, §130.2, §130.4, §140.7 and §141.0. §150.0(k)10:Internally illuminated address signs shall comply with §140.8; or shall consume no more than 5 watts of power as determined according to §130.0(c). §150.0(k)11: Lighting for residential parking garages for eight or more vehicles shall comply with the applicable requirements for nonresidential garages in §110.9, §130.0, §130.1, §130.4, §140.6, and §141.0. §150.0(k)12A: In a low-rise multifamily residential building where the total interior common area in a single building equals 20 percent or less of the floor area, permanently installed lighting for the interior common areas in that building shall be high efficacy luminaires or controlled by an occupant sensor. §150.0(k)12B: In a low-rise multifamily residential building where the total interior common area in a single building equals more than 20 percent of the floor area, permanently installed lighting in that building shall: i. Comply with the applicable requirements in §110.9, §130.0, §130.1, §140.6 and §141.0; and ii. Lighting installed in corridors and stairwells shall be controlled by occupant sensors that reduce the lighting power in each space by at least 50 percent. The occupant sensors shall be capable of turning the light fully On and Off from all designed paths of ingress and egress. Solar Ready Buildings: §110.10(a)1: Single family residences located in subdivisions with ten or more single family residences and where the application for a tentative subdivision map for the residences has been deemed complete, by the enforcement agency, on or after January 1, 2014, shall comply with the requirements of §110.10(b) through §110.10(e). §110.10(a)2: Low-rise multi-family buildings shall comply with the requirements of §110.10(b) through §110.10(d). §110.10(b)1: The solar zone shall have a minimum total area as described below. The solar zone shall comply with access, pathway, smoke ventilation, and spacing requirements as specified in Title 24, Part 9 or other Parts of Title 24 or in any requirements adopted by a local jurisdiction. The solar zone total area shall be comprised of areas that have no dimension less than 5 feet and are no less than 80 square feet each for buildings with roof areas less than or equal to 10,000 square feet or no less than 160 square feet each for buildings with roof areas greater than 10,000 square feet. For single family residences the solar zone shall be located on the roof or overhang of the building and have a total area no less than 250 square feet. For low-rise multi-family buildings the solar zone shall be located on the roof or overhang of the building or on the roof or overhang of another structure located within 250 feet of the building or on covered parking installed with the building project and have a total area no less than 15 percent of the total roof area of the building excluding any skylight area. §110.10(b)2: All sections of the solar zone located on steep-sloped roofs shall be oriented between 110 degrees and 270 degrees of true north. §110.10(b)3A:No obstructions, including but not limited to, vents, chimneys, architectural features, and roof mounted equipment, shall be located in the solar zone. §110.10(b)3B: Any obstruction, located on the roof or any other part of the building that projects above a solar zone shall be located at least twice the distance, measured in the horizontal plane, of the height difference between the highest point of the obstruction and the horizontal projection of the nearest point of the solar zone, measured in the vertical plane. §110.10(b)4:For areas of the roof designated as solar zone, the structural design loads for roof dead load and roof live load shall be clearly indicated on the construction documents. §110.10(c): The construction documents shall indicate: a location for inverters and metering equipment and a pathway for routing of conduit from the solar zone to the point of interconnection with the electrical service (for single family residences the point of interconnection will be the main service panel); a pathway for routing of plumbing from the solar zone to the water-heating system. §110.10(d):A copy of the construction documents or a comparable document indicating the information from §110.10(b) through §110.10(c) shall be provided to the occupant. §110.10(e)1: The main electrical service panel shall have a minimum busbar rating of 200 amps. §110.10(e)2: The main electrical service panel shall have a reserved space to allow for the installation of a double pole circuit breaker for a future solar electric installation. The reserved space shall be: positioned at the opposite (load) end from the input feeder location or main circuit location, and permanently marked as For Future Solar Electric. Phuong Devries 07/15/16 Page 1 of 5 CalGreen_2014.doc revised 11/04/14 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: Project Address: Project Description: 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 shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. MANDATORY FEATURE OR MEASURE Column 2 Column 3 Project Requirements Verification A4.1 PLANNING AND DESIGN 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. 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@cupertino.org SEETHARAM RESIDENCE 10198 RICHWOOD DR CUPERTINO CA 95014 INTERIOR REMODEL, ADDITION OF BAY WINDOW, NEW PORCH ROOF X X Phuong Devries 07/15/16 Page 2 of 5 CalGreen_2014.doc revised 11/04/14 A4.2 ENERGY EFFICIENCY 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. X X X Phuong Devries 07/15/16 Page 3 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 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. A4.5 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 shall be compliant with product weighted MIR Limits for ROC and other toxic compounds. X X X X X X Phuong Devries 07/15/16 Page 4 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. 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 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. X X X X X Phuong Devries 07/15/16 Page 5 of 5 CalGreen_2014.doc revised 11/04/14 CALGREEN SIGNATURE DECLARATIONS Project Name: Project Address: 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. Owner’s Signature Date Owner’s Name (Please Print) Design Professional’s Signature Date Design Professional’s Name (Please Print) 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 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 SEETHARAM RESIDENCE 10198 RICHWOOD DR, CUPERTINO INTERIOR REMODEL, ADDITION OF BAY WINDOW, NEW PORCH ROOF VARSHA NENE 5/2/16 SHIRISH SEETHARAM 5/4/2016 5/42016 Phuong Devries 07/15/16