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15120077CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120077 10095 SAICH WAY (326 32 041) SMICONX CONSTRUCTION 2051 JUNCTION AVE SAN JOSE, CA 95131 OWNER'S NAME: (SAICH WAY STATION LLC) DATE ISSUED:. 07/29/2016 OWNER'S PHONE: 408-453-4700 PHONE NO: 408-418-0099 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CONTRACTOR - GENERAL Lie. #983292 Contractor SILICONX CONSTRUCTION Date 06/30/2016 —BLDG —ELECT _ PLUMB MECH 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: TENANT IMPROVEMENT FOR FUTURE TENANT (1605 SQ I hereby affirm under penalty of perjury one of the following two declarations: FT). 1. I have and will maintain a certificate of consent to self-insure for Worker's ompensation, as provided for by Section 3700 of the Labor Code, for the ,performance ofthe work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $50000.00 permit is issued. 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 326 32 041 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per theertno Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED IN CTION. Signature Date 07/29/2016 Issued by: MELISS Date: 07/29/2016 OWNER-BUILDER DECLAIL4TION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 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 (See.7044, Business & Professions Code) 2. 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: 07/29/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 1 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 2. 1 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. _ Health & Safety Code, Section 25532(a) should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment 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 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 Cade, tions 2550-5,25 3, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent APPLICANT CERTIFICATION Dater 07/29/2016 certify that I have read this application and state that the above information is N ON LE I hereby affirm that there is a construction lending agency for the performance correct. L 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 ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 07/29/2016 professional COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE,AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a cupertlnO.Orq /,,y 77 ONEW CONSTRUCTION ❑ ADDITION M AT.TFRATHIN/TT F-1 RFVTRTnNT/nrFFRRFn nRTnTT.TAT DVDAAT-rtl PROJECT ADDRESS 10095 SA I C H WAY, C U P E RTI O N APN # 326-32-041 OWNER NAME -�1�v PxIg-453-4700 EX1.35 E-MAIL MIKE KRONZER Y mike borelli.com F STREET ADDR-YAr 51 JUNCTION AVE, SUITE 100 CITY, STATE, ZIP SAN JOSE, CA 95131 FAX CONTACT NAM. PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 11 CONTRACTOR 11 CONTRACTOR AGENT ARCHITECT 11 ENGINEER 11 DEVELOPER ❑ TENANT CONTRACTORNAME TONY GONZALEZ LICENSE NUMBER LICENSE TYPE BUS. LIC# COMPANYNAMESILICONX CONSTRUCTION, IN E-MAIL ton siliconnonstruction.co FAX 408-453-5636 STREET ADDRESS 2051 JUNCTION AVE, #100 CITY, STATE, ZIP SAN JOSE, CA 95131 PHONE408-418-0099 ARCHITECT/ENGINEER NAMEJEFFRE I EATON, LICENSE NUMBER .026469 V BUS. LIC# COMP�N�EATON HALL ARCHITECTURE E -MAH' Jeffrey@ehastudio.com ehastudio.com F` x 408-265-6155 STREET ADDRESS 1501 THE ALAMEDA STE 105 CITY, STATE, ZIP SAN JOSE, CA 95126 PHONE 408-265-5255 DESCRIPTION OF WORK TENANT IMPROVEMENT PROPOSED DEMISING WALL, ACCESSIBLE UNISEX RESTROOM, CEILING, ELECTRICAL, PLUMBING, MECHANICAL DUCTING EXLSTINGUSE - PROPOSED USE CONSIR. TYPE # STORIES NEW SHELL V_B 1 1 USE TYPE occ. sQ.FT. VALUATION(�) EXISTG NEW FLOOR DEMO TOTAL AREA 1,605 AREA 1,605 AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA AREA GARAGE AREA: DETACH I =ORCH []ATTACH #DWELLING UNITS: IS ASECOND UNIT ❑YES SECONDSTORY []YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES ii.ECEI i'i T TAL. VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO ZEN 50/ ,...... co C7 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 buil ction. I ut representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: f2hfi5— SUPPLEMENTAL INFORMATION REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for�N' [#�#S7U1�£�Ep.TiNIZ��K. existing building(s). Demolition permit is required prior to issuance of building permit for new building.''1?.SIZES z1GI�jl`IGtCitli Commercial Bldgs: Provide a completed Hazardous Materials Disclosurer�ND tDpsL1C� ' form if any Hazardous Materials are being used as part of this project. 1e11 �� Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. M Z �Ts�It Bldg,4pp SPEC 2 11.doc revised 06/21/11 CITY OF CUPERTINO FEF ESTIMATOR — BUILDING DIVISION 10095 Saich Way FEE DATE: 12108/2015 REVIEWED BY: Sean JimADDRESS: APN: BP#: F dT. 00 `"VALUATION: $50,000 „PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY- USE: Commercial Building Suppl. PC Fee: (E) Reg. (0 OT Q.0 PENTAMATION PERMIT TYPE: 1 M TI WORK Tenant Improvement for future tenant 1605 sq ft). SCOPE _ TYPE OF FLR AREA OCCUPANCY TYPE: PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. (s.f.) M (Tenant Improvements) II-B,111-B,IV,V-B 1,605 j $3,004.68 ) IMTIPLNCK $1,532.96 IMTHNSP TOTALS: 1,605=3,004.68 $1,532.96 NOTE. This estimate does not include -fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District- etci These fees are based on the relimina in ormation available and are on1v an estimate. Contact the Dept jor aaan't info. FEE ITEMS f>~'ee Kesolutio. n .1.1-053 Efit' 7.1/13) FEE QTY/FEE MISC ITEMS _. r"� Fee: F dT. 00 $3,004.6$ Select a Mise Bldg/Structure or Element of a Building .. o. f'Y - Suppl. PC Fee: (E) Reg. (0 OT Q.0 hrs ti ,us - - z, f,'f?... h e•,sp ��}} 3' P V LGA ", .3 i✓'.�3 $0.00 Permit Fee: $1,532.96 Suppl. Insp. Fee.0 Reg. Q NOTE. This estimate does not include -fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District- etci These fees are based on the relimina in ormation available and are on1v an estimate. Contact the Dept jor aaan't info. FEE ITEMS f>~'ee Kesolutio. n .1.1-053 Efit' 7.1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,004.6$ Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: (E) Reg. (0 OT Q.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,532.96 Suppl. Insp. Fee.0 Reg. Q OT Q,p hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consh-m--tion 7�,Ix: Adrninislraiiv�, - Work Without Permit? C) Yes No $0.00 Advanced. l'Iannin Fee: $0.00 Select a Non -Residential Building or Structure Strom Motion F&: IBSEISMICO $14.00 Select an Administrative Item BlIg Stds Commission Fee: IBCBSC $2.00 -SUBTOTALS , $4,553.64 $0.00 1, OTALPEE: $4,553.64 meviseu. lulu iiw iu Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # GENERAL CONTRACTOR:a' I; BUSINESS LICENSE # ADDRESS: V CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical QV1 e, rk (� Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing 1 Heating v Insulation Landscaping Lathing Masonry Painting / Wallpaper e C Paving Plastering . Plumbing ' '? Roofing etaiCK L2 Septic Tank Sheet Metal Sheet Rock (0 LV i(0— Tile Tile Owner / Contractor Signature Date CUPERTINO PURPOSE: CALGREEN NON-RESIDENTIAL CHECKLIST — MANDATORY ITEMS RECEIVED COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a()cupertino.orq i 13 --� The non-residential provisions of the 2013 CalGreen Code outline planning, design and development methods that include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines means of reducing the quantity of air contaminants. FIGE C"' Project Name: UBREAKIT/SPECULATIVE SPACE 2 Project Address: 10095 SAICH WAY, CUPERTINO, CA 95104 Project Description: TI PROPOSED DEMISING WALL, ACT CEILING, ELECTRICAL, PLUMBING, MECHANICAL DUCTING. Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project.n '� 2. The licensed professional, in collaboration with the owner and the desigr9 ro es Moria s h N a mittal 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 corgpleted form AgthDLSFqrJ*WOspector. artm De Buildinq P ent Page 1 of 9 CalGreen Non -Res Checklist. doc revised 01123/14 Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification F Requirements CHAPTER General Requirements The project meets all the requirements of Divisions 5.101 through 5.508. ❑X ❑ DivisionPLANNING Planning and Design - Site Development 5.106.1 Storm water pollution prevention. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been designed, specific to its site, conforming to the State Storm water NPDES Construction Permit or local ordinance, whichever is stricter, as is required for projects over one acre. The plan should cover prevention of soil loss by storm water run-off and/or wind erosion, of sedimentation and/or of dust/particulate matter air pollution. Page 1 of 9 CalGreen Non -Res Checklist. doc revised 01123/14 5.106.4 Bicycle parking. Comply with Sections 5.106.4.1 and 5.106.4.2; or meet local ordinance, whichever is stricter. ❑ ❑ 5.106.4.1.1 Short -Term bicycle parking. If the qualified project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers-by, ❑ ❑ for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two -bike capacity rack. 5.106.4.1.2 Long -Term bicycle parking. For qualified buildings with over ❑ ❑ 10 tenant -occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low -emitting, fuel-efficient and carpool/van pool vehicles as ❑ ❑ shown in Table 5.106.5.2. 5.106.8 Light pollution reduction. Outdoor lighting systems shall be ❑ ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones ❑ ❑ 1 — 4 as defined in Chapter 10 of the California Administrative Code; and 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM -15-11; and ❑ ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or ❑ ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 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. Division Performance Requirements 5.201.1 Scope. The California Energy Commission will continue to adopt ❑XElmandatory building standards. Division• • Indoor Water Use 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1.1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. ❑ ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the E]❑ building projected to consume more than 100 gal/day. 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater ❑ ❑ than 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot-water boilers with energy input > 500,000 Btu/h. Page 2 of 9 CalGreen Non -Res Checklist. doc revised 01/23114 5.303.1.2 Excess consumption. A separate submeter shall be provided for any tenant within a new building or within an addition that is projected ❑ ❑ to consume > 1,000 gal/day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate in Table ❑X ❑ values shown 5.303.2.3. Exception: Building that demonstrate 20-percent overall water use reduction. 5.303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall ❑X ❑ apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water-conserving fixtures or ❑ 2. Utilizing non-potable water systems. ❑ 5.303.6 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code ❑ El(CPC), and shall meet the applicable standards referenced in CPC Table 1401.1 and CalGreen Chapter 6. Outdoor Water Use 5.304.1 Water budget. A water budget shall be developed for landscape ❑ ❑ irrigation use. 5.304.2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least ❑ ❑ 1,000 sq.ft. but not more than 5,000 sq.ft., separate submeters or metering devices shall be installed for outdoor potable water use. 5.304.3 Irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft. of cumulative landscaped area, install irrigation controllers and sensors which include following ❑ ❑ the criteria, and meet manufacturer's recommendations. 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 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. 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 communicates ❑ ❑ with the controller(s). Soil moisture-based controllers are not required to have rain sensor input. Weather Resistance and Moisture Management 5.407.1 Weather protection. Provide a weather-resistant exterior wall and foundation envelope as required by California Building Code Section 1403.2 ❑ ❑ and California Energy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent.' Page 3 of 9 CalGreen Non -Res Checklist. doc revised 01/23114 5.407.2 Moisture control. Employ moisture control measures by the following methods; 5.407.2.1 Sprinklers. Prevent irrigation spray on structures. 5.407.2.2 Entries and openings. Design exterior entries and/or openings to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following: 1. An installed awning at least 4 ft in depth. 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection. 5.407.2.2.2 Flashing. Install flashings integrated with a drainage ❑ plane. Construction Waste Reduction, Disposal and Recycling 5.408.1 Construction waste management. Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408.1.1, 5.408.1.2, or 5.408.1.3; or meet a QX local construction and demolition waste management ordinance, whichever is more stringent. 5.408.1.1 Construction waste management plan. Submit plan per this section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408. 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square M ❑ foot of building area may be deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5.408.1.4 Documentation. Provide documentation of the waste management plan that meets the requirements listed in Section 5.408.1.1 through 5.408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land clearing shall be reused or recycled. Building Maintenance and Operation 5.410.1 Recycling by occupants. Provide readily accessible areas that serve the entire building and are identified for the depositing, storage and collection ❑X of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the design and construction processes of the building project. Commissioning requirements shall include items listed in Section 5.410.2. Page 4 of 9 CalGreen Non -Res Checklist. doc revised 01/23 14 5.410.2.1 Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in ❑ ❑ Section 5.410.4. 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems ❑ ❑ listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of ❑ ❑ the building project and shall include items listed in Section 5.410.2.3. 5.410.2.4 Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each component, system and system -to -system interface in accordance with the ❑ ❑ approved plans and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems operations training are required. ❑ ❑ 5.410.2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall ❑ ❑ include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type and/or system El shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and ❑ ❑ reporting recommendations for post -construction phases of the building project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303.1. 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall include, as applicable to the project, the systems listed in Section ❑X ❑ 5.410.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards ❑ ❑ on each system. 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a building or space is operated for normal use, the system should be balanced in accordance with the procedures defined by ❑X national standards listed in Section 5.410.3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for ® 1:1performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of El El for each system prior to final inspection. 5.410.4.5.1 Inspections and reports. Include a copy of all inspection verifications and reports required by the enforcing agency. 0 ❑ Page 5 of 9 CalGreen Non -Res Checklist. doc revised 01/23/14 Fireplaces 5.503.1 Install only a direct -vent sealed -combustion gas or sealed wood - burning fireplace or a sealed woodstove and refer to residential requirements ❑ ❑ in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase II emission limits. ❑ ❑ Pollutant Control 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component ❑X ❑ openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or ❑ ❑ SCAQMD Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and other ❑X ❑ requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall comply with Table 5.504.4.3 unless more stringent local limits apply. ❑X ❑ 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on use of ❑ ❑ certain toxic compounds and ozone depleting substances (CCR, Title 17, Section 94520 et seq). 5.504.4.3.2 Verification. Verification of compliance with this section shall be provided at the request of the enforcing agency. ❑X ❑ 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards ❑ ❑ listed in Section 5.504.4.4. 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute ❑ ❑ Green Label program. 5.504.4.4.2 Carpet adhesive. All carpet adhesive shall meet the requirements of Table 5.504.4.1. ❑X ❑ Page 6 of 9 CalGreen Non -Res Checklist.doc revised 01/23/14 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for ❑X ❑ formaldehyde as specified in Table 5.504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section ❑ ❑ shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following standards listed in Section 5.504.5.3. 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one ❑ ❑ of the following standards listed in Section 5.504.4.6. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and ® ❑ return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced ❑%� ❑ by ordinances, regulations or policies of any city, county, city and county, California Community College, campus of the California State University or campus of the University of California, whichever are more stringent. Indoor Moisture and Radon Control 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203 ® ❑ and Chapter 14.1. Air Quality and Exhaust 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California ❑X ❑ Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with demand control ventilation, CO2 sensors and ventilation controls shall be ❑ ❑ specified and installed in accordance with the requirements of the latest edition of the California Energy Code, CCR, Title 24, Part 6, Section 121(c).' Environmental Comfort 5.507.4 Acoustical control. Employ building assemblies and components STC ❑ ❑ with values determined in accordance with ASTM E 90 and ASTM E 413. 5.507.4.1 Exterior noise transmission. Wall and floor -ceiling assemblies making up the building envelope shall have an STC of at least 50 and exterior windows shall have a minimum STC of 30 for any of the building ❑ ❑ locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4.2 Interior sound. Wall and floor -ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of ❑ at least 40. Page 7 of 9 CalGreen Non -Res Checklist. doc revised 01/23/14 Outdoor Air Quality 5.508.1 Ozone depletion and greenhouse gas reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration equipment that does not contain CFCs. 5.508.1.2 Halons. Install fire suppression equipment that does not contain a ❑ Halons. Page 8 of 9 CalGreen Non -Res Checklist. doc revised 01/23/14 CALGREEN SIGNATURE DECLARATIONS Projactmarne: UBREAKIT/SPECULATIVE SPACE2 Project Address: 10095 SAICH WAY,•CUPERTION 95104 ProjectDeacriptlon: rpsoroaeaoeamsnxrMu.AcrCauNa.Aecas5BLEUNxacnessncou,ececmC& PLuuerro,MW"Aac+uLm="0 SECTION I - DESIGN VERIFICATION Complete eA lines of section 1-- "Cestan vefteiion" and subenii the completed checklist (Columns 1 and 2) with the plans and building permit application to the &Wns Oepertment. The owner end design professional responsbte for compliance with CalGrean Standards have mWW the pians and canny thatthe Pjms checked above we hereby Incorporated Into the project plans and A be tmplsnwnted into the pIn anee with the requirements set forth In the 2013 Cakfomin Green Building Stendefda Code as e ed by CAy of Cuperihw. T�_ U6- en's Dale i all own 2 � Design dfudanarsisivMML, Data Oacign Pro 1's 0 t o S se Professional reapanalble for CalOreen compliance W" Neme of iLkw Professional raeponetMa far CeKkeen compliance (Plenty Pdnq Phone . 1 _ . F -Mail nse Professional mWonalble for Calorsan compliance SECTION 2 -- Complete, elfin and submit the competed checkbl, Including column 3. together with all original stgnaturas on Section 2 to the Building Department prior to Building Department final Inspection. I have Inspected the work and have received sufficient docurnw tation to var2y and cerHy that the pfojaot Idewilied above waa constructed In accaaEertce with this Green D Ading Chock(ist and to accordance with the raquiremenis of Ow 2013 Cakfomle Gmen Building Standards Code as adopted by the City of Cupertino. 6ignalure of License Prolseelwwl rosparelbie for Calomn compllance Dole Name of License Professlonal mspon*k far Cel0men campnanas (Please Print) phone P8F 9 0179 COMrtm Nan,lfa: ChrrifWAOC MLwd V1?JY4