B-2016-1913CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1913
22025 CREEKSIDE CT.CUPERTINO, CA 95014-1103 (326 39 039)
RICH MATHERS
CONSTRUCTION INC
LOS ALTOS, CA 94023
OWNER'S NAME: BHORKAR ABHAY AND MODAK MANSI
DATE ISSUED: 08/08/2016
OWNER'S PHONE:
PHONE NO: (650) 941-821$
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic. #674167
Contractor RICH MATHERS CONSTRUCTION INC Date 11/30/2016
X BLDG —ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
X— 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:
ADD 129 S.F. TO EXTEND KITCHEN & ADD (I) BATH;
I hereby affirm under penalty of perjury one of the following two declarations:
RECONFIGURE/REMODEL 1,138 S.F. AREA. REPLACE/RELOCATE
1. 1 have and will maintain a certificate of consent to self-insure for Worker's
HVAC
Compensation, as provided for by Section 3700 of the Labor Code, for the
REV #1 - STRUCTURAL CHANGES TO CEILING FRAMING IN
performance of the work for which this permids issued.
LIVING ROOM- ISSUED 8131/2016
2. I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued,
Sq. Ft Floor Area: 129
Valuation: $175000.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
326 39 039
Deferred Submittal (R-3),R-3 (Custom)
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 the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date Date
Issued by: Abby A e� nde
OWNER-BUILDER. DECLARATION
Date: 08/08/2016
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. 11 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. 1, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Scc.7044, Business & Professions Code).
Date:
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
2. 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
a. 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 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. lf, 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 25505, 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:
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
CONSTRUCTION LENDING AGENCY
1 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 regulationsper the Cupertino Municipal
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date
Professional
CUPERTINO
M NEW CONSTRUCTION
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - building0cuDertino.org
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DESCRIPTION OF WORK F(LAM 6
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PR&APPLICATION 0 YES IF YES, PROVIDE COPY OF
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RECEIVED BY,
TOTAL VALUATION:
PLANNING APPL # [3NO PLANNING APPROVAL LETTER
EICHLERHOMEY ! [3 NO
By my signature below, I certify to each of the following: I am the property
towner or authorized agent to act on the property owner's behalf I have read this
application and the information I have provideditcorrect. I Vvve read the Description
of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to build' nstru tion 10 representatives
of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicam/Agem:
Date: 1 I-zo I Ifle
SUPPLEMENTAL INFO `�TIO7 REQUMED
PLAN - VUECKTYPV
RCIT3TING SUP
New SFD or Multifamily dwellings: Apply for demolition permit for
n OVER THE -COUNTER,
0 BUILDINGPLANUVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
0 MUESS
PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
11 STANDARD
❑ PUBUCWORKS
To—rm. if any Hazardous Materials are being used as part of this projec t.
0 LARGE
0FIRE DEPT_
— Copy of Planning Approval Letter or Meeting with Planning prior to
0 mmou
0 SANITARY SEWER DISTRICT
submittal of Building Permit application.
11 ENVIRONMENTAL HEALTH
BIdgApp_M1 L doe revised 06121111
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1913
22025 CREEKSIDE CT CUPERTINO, CA 95014-1103 (326 39 039) RICH MATHERS
CONSTRUCTION INC
LOS ALTOS, CA 94023
OWNER'S NAME: 13HORKAR ABRAYAND MODAK MANSI
OWNER'S PHONE: 408-242-2169
LICENSED CONTRACTOR'S DECLARATION
License Class B Lic. # 7f 4167
Contractor RICH MATHERS QQNSTRi 1CTION INC Date 11/30/2016
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
i. I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2: I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code„ for the performance of the work for which this
`� pe`rinit is issued.
APPLICANT CRTIFI ATION
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 applic� t understan and will comply with all non -point
source regulations Tr he Cupertin Mun' 'pal Code, Section 9,18.
Signature Date/ /8 8 2016
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)
2. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (See.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. 1 have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
3. 1 certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws
relating to building construction, and hereby authorize representatives of this city
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature Date 8/8/2016
ISSUED: 08/08/2016
NO: (650) 941-8218
PERMIT INFO:
X BLDG —ELECT -PLUMB
X MECH X RESIDENTIAL COMMERCIAL
DESCRIPTION:
129 S.F. TO EXTEND KITCHEN & ADD (N), BATH;
DNFIGURE/REMODEL 1,138 S.F. AREA. REPLACE/RELOCATE
Ft Floor Area: 129 1 Valuation: $175000.00
APN Number: Occupancy Type:
326 39 039 R-3 (Custom)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
by: Abby Ayendc
Date:
REROO
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: 8/8/2016
ALL ROOF COVERINGS TO BE CLASS "A"
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with theCupe Municipal Code, Chapter 9.12 and
the Health & Safety Code, cti s 25505, 25533 25534.
Owner or authorized agent•
Date: 8/8/2016
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CUPERTINO
Address
Lei
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 buildingp_cupertino.org
PERNUT CANNOT,BE FINALED AND -COMPLETED UNTIL THIS CERTIFICATE
HAS BEEN AND I2T{ 12NED TO THE BUILDING DIVISION
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000,00, CRC Section R314 and CSC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM
_
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling "unit including basements
X
X _
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units,, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by,means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
t, ,. .a 11 n fn nmmWith tha tarm.c and rnnrlitions of this statement
Owner (or Owner Agent'Name: `
--
d
�
)bie
�v"��
Si nature.................................................................... Date: ...................
................
_s)
Contractor Name:
IC�k, Plat l�-
9
Lic.#6 Date:..
IQ....c.
Signature. �:...................................................................,..................... ..............
Smoke and CO fonn.doe revised 03/18114
Owner Name
WATER -CONSERVING F -
OWNER CERTIFICATE OCOMPLIANCE.
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 77.7-3228 • FAX (408) 777-3333 . building aacupertino.orq
Permit No l' I
Address
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
% No Go to Question 2.
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
plumbing, installation of water -conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom_ of form.
12 No Go to Question 4.
4. Is your real property built and available for use or, occupancy on or before January 1, 1994?
❑ No My real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
j1 Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Please check ONE of the following:
My property is a single family-residbntial real property. See Civil Code Section 1101.4.
Ori and after January 1, 2014, building alterations or improvements shall require _all- non-compliant plumbing fixtures
to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-
compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether
property undergoes alterations or improvements).
❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. _
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements).
I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the followinz pale. . , , I V A
Owner or Owner Agent's Signature: Z--- A -Z" `` - — Y Date: / 'IT / " /
Upon completing and signing this Certificate, please return it to the Building Division in order to nnai your ouuaing permit.
SB407 2015.doc revised 08/26/15
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure sho�nl, it is not required to be upgraded.
SB407 2015.doc reVised 08/26/15
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture/
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CFC Ch. 4
/Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
.Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush'
Gallons/flush
Showerheads
Exceed 2.5
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, 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 @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets —
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi .
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum .0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 psi
Faucets -
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 .gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
minute @ 60 psi, and must
gallons per minute @
default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure sho�nl, it is not required to be upgraded.
SB407 2015.doc reVised 08/26/15
CALGREEN SIGNATURE DECLARATIONS
Project Name: Abhay Bhorkar and Mansi Modak project residence
Project Address: 22025 Creekside Ct., Cupertino, CA., 95014
Project Description. Add'€tion at the (E) Kitchen / new hath, alteration to hal[, HVAC, lighting, floorin
.............
SECTION f - 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 xoject plans and will be implemented into the
project in accordance with the requirements set forth in the 2013 California Leen Building Standards Code as
adopted by the City of Cupertino.
7-1
Owner's Signature Date
Abhay Bhorkar
Owner's Name (Please Print)
7/27/16
Design Professional's Signature Date
David Torras
Design Professional's Name (Ple a Pr
07/29/2016
Signature of License Professional r ponsib for compliance Date
Jamshid (Jam) Hezar-AI i nce 24 Ti e- Calgreen Inspector#8099390 (530) 902-4387
Name of License Profession responsible f CalGreen compliance (Please Print) Phone
a24t@att.net
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 tiave inspected the work and have received sufficient documentat'�)n 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 Cade as adopted by the City of Cupertino.
Signature of License Professional responsible for CalGreen compliance
Jamshid (Jam) Hezar- Alliance 24 Title-Calgreen Inspector # 8099390
Name of License Professional responsible for CalGreen compliance (Please Print)
a24t@att.net
Email Address for License Professional responsah��_f�� � ]Green
Building Department
Date
(530) 902-4387
Phone
Page 5of5 REVIEWED FOR CODE COMPLIANCE CalGreen_2014.docrevised 11104114
Reviewed By:Arnold Hom
Date: 08/02/16
CUPERTINO
PURPOSE:
CALGREEN RESIDENTIAL CHECKLIST - MANDATORY
ITEMS
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(alcupertino.org
The 2013 CalGreen Code applies to additions or alterations of existing residential buildings where the addition
or alteration increases the building's conditioned area, volume, or size and also applies to all new low-rise
residential buildings, high-rise residential buildings, or both. Existing site and landscaping improvements that
are not otherwise disturbed are not subject to the requirements of CALGreen.
Project Name: Abhay Bhorkar and Mansi Modak project residence
Project Address: 22025 Creekside Ct., Cupertino, CA., 95014
Project Description: Addition at the (E) Kitchen / new bath, alteration to hall, HVAC, lighting, flooring
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.
Column 2 Column 3
MANDATORY FEATURE OR MEASURE Project Verification
Reauirements
Planning and Design - Site Development
4.106.2 Storm water drainage and retention during construction. A plan is
developed and implemented to manage storm water drainage during ❑ ❑
construction.
4.106.3 Grading and paving. The site shall be planned and developed to
keep surface water away from buildings. Construction plans shall indicate how Q ❑
site grading or a drainage system will manage all surface water flows.
CUPERTINO
Building Department
REVIEWED FOR CODE COMPLIANCE
Page 1 of 5 Reviewed By:Arnold HOM CalGreen_2014.doc revised 11/04/14
Date: 08/02/16
General
4.201.1 Low-rise residential buildings shall meet or exceed the minimum
standard design required by the California Energy Standards.
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 r in Table 1401.1 of the
California Plumbing Code. _ CUPERTINO
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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
0
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. CUPERTINO
4.504.2.3 Aerosol paints and coatings.attfl0tlgoDepado"
Ls
shall be compliant with product weighted for ROC and other toxic
0
compounds. REVIEWED FOR CODE COMPLIANCE
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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
0
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
0
discipline they inspect and verify.
Verifications
703.1 Documentation. Verification of com fiance with CALGreen may
include construction documents, plans, bp,ns, bpr I
inspection tt��f1Tdt'cing
certification, reports, or other m o ccep�bf�
agency which show substantial conforma rRw1htiag\0s nmestbll
be submitted to the Building Department a mentation of all required
measures and prior to final inspection appRAWED FOR CODE COMPLIANCE
Page 4 of 5 Reviewed By:Arnold HOm CalGreen_2014.doc revised 11/04/14
Date: 08/02/16
Project Name
Project Address
Project Description
CALGREEN SIGNATURE DECLARATIONS
Abhay Bhorkar and Mansi Modak project residence
22025 Creekside Ct., Cupertino, CA., 95014
Addition at the (E) Kitchen / new bath, alteration to hall, HVAC, lighting, floorin
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
Abhay Bhorkar
Owner's Name (Please Print)
Design Professional's Signature Date
David Torres
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
Name of License Professional responsible for CalGreen compliance (Please Print)
Email Address for License Professional
Page 5 of 5
REVIEWED FOR CODE COMPLIANCE
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Date: 08/02/16
Date
Phone
CalGreen_2014.doc revised 11/04/14
ADDITIONS LOCATED IN FLOOD HAZARD AREAS
COMMUNITY DEVELOPMENT DEPARTMENT • PUBLIC WORKS DEPARTMENT
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org
CUPERTINO
BACKGROUND
The City of Cupertino establishes requirements for the prevention of flood damage in Chapter
16.52 of the Cupertino Municipal Code. The purpose of this policy is to further clarify the
requirements for additions to buildings and structures located within the boundaries of a flood
hazard area.
DEFINITIONS:
ADDITION: An extension or increase in floor area or height of a building or structure.
ALTERATION: Any construction or renovation to an existing structure other than repair or
addition that requires a permit. Also, a change in a mechanical system that involves an
extension, addition or change to the arrangement, type or purpose of the original installation
that requires a permit.
POST -FIRM BUILDING: A building for which construction or substantial improvement
occurred after December 31, 1974, or on or after the effective date of the initial Flood
Insurance Rate Map (FIRM) for the community.
PRE -FIRM BUILDING: A building for which construction or substantial improvement occurred
on or before December 31, 1974, or before the effective date of the initial Flood Insurance
Rate Map (FIRM) for the community.
SUBSTANTIAL IMPROVEMENT: "Substantial improvement" means any repair,
reconstruction or improvement of a structure, the cost of which equals or exceeds fifty percent
of the market value of the structure either:
1. Before the improvement or repair is started; or
2. If the structure has been damaged and is being restored, before the damage occurred.
For the purposes of this definition "substantial improvement" is considered to occur
when the first alteration of any wall, ceiling, floor or other structural part of the building
commences, whether or not that alteration affects the external dimensions of the
structure. The term does not, however, include either:
1. Any project for improvemM
stru�t�� t"so
with existing state or local health,
sanitary, or safety codesions w'h� arly necessary to assure safe living
conditions; or Building Department
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2. Any alteration of a structure listed on the National Register of Historic Places or a State
Inventory of Historic Places.
EXAMPLES OF SUBSTANTIAL IMPROVEMENT
Substantial Improvement to an existing building may be the result of an alteration to an existing
building, an addition to an existing building, or a combination of both. The following examples
will clarify how the Cupertino determines if an improvement to an existing building is
considered a substantial improvement.
EXAMPLE 1: 100% alteration of an existing 1000 s.f. building; No addition.
Assume: Market Value for existing structure = $150/s.f.
Alteration of existing structure = 50% cost of Market Value = $75/s.f
Calculate:
Market Value of Existing Structure = 1000 s.f. x $150/s.f. = $150,000 Improvement
Value = 1000 s.f. x $75/s.f. = $75,000
Value Increase (%) = 50% Market Value [Scope is consider Substantial Improvement]
EXAMPLE 2: 500 s.f. addition to an existing 1000 s.f. building; No alteration.
Assume: Market Value for existing structure = $150/s.f.
Construction Valuation of Addition = $150/s.f
Calculate:
Market Value of Existing Structure = 1000 s.f. x $150/s.f. = $150,000 Improvement
Value = 500 s.f. x $150/s.f. = $75,000
Value Increase (%) = 50% Market Value [Scope is consider Substantial Improvement]
EXAMPLE 3: 300 s.f. addition to an existing 1000 s.f. building; Alteration to 40% of
existing structure.
Assume: Market Value for existing structure = $150/s.f.
Alteration of existing structure = 50% cost of Market Value = $75/s.f
Constructio - ion of Addition = 150/s.f
CUPERTIN
NO
Calculate: .• a Building Department
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Date: 08/02/16
Market Value of Existing Structure = 1000 s.f. x $150/s.f. = $150,000
Improvement Value = 300 s.f. x $150/s.f. + 400 s.f. x $75/s.f. = $75,000
Value Increase (%) = 50% Market Value [Scope is consider Substantial Improvement]
SUBSTANTIAL IMPROVEMENT CALCULATOR
Area of existing building
1799
Area of existing garage
424
Area of remodel of existing building
1332
Area of remodel of existing garage
0
Area of addition
129
Substantial Improvement?
Assuming $150/s.f. (and incl. Garage)
Existing structure = (1799+424)$150 =$333,450
Cost of PV Improvement (18 panels) = $18,000
Improvement Value = (129)*$150+1332*$75 + $18,000 = $137,250
% Improvement = 41%
PERMIT REQUIREMENTS:
If an addition constitutes a substantial improvement to a building, both the addition and the
existing building must comply with the effective base flood elevation, foundation, and other
flood requirements for new construction.
If an addition to a pre -FIRM building does not constitute a substantial improvement, neither the
addition nor the existing building must be elevated.
If an addition to a post -FIRM building does not constitute a substantial improvement, the
addition must be elevated in accordance with current flood requirements.
CUPERTINO
Building Department
REVIEWED FOR CODE COMPLIANCE
Reviewed By:Arnold Hom FloodMitigation_2015.doc revised 09101115
Date: 08/02/16