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02060030TY OF CUPERTHNO 0 Ctu� 7YOF FERMET APP LEC ATEON I�®I�I�YI1 0�'I,rj60030 APN # Fee Description Date ®, 05 A2— APTFEE Building Addre � q U 64 LG AVE, CUPEkTlrvo 1 CA 9s -v � Owner's Name: PADAlA �U AC � Phone #� o - Z S 3— 21 S Contractor ' BAPPLOTHER License #: MECHANICAL Contact: K Construction Tax Phone #: BCONSTAX Applicant/Contraptor� BUILDING Fax #: Con. Tax for BQ Zone "Buil. ' g Permit Info: ' Hotel and Motel Bld Elec Pl Mech Constax — Resi/Mobile J1Descriptio Residential: ornmercial: Elec 600V <=1000A Sq.Ft. Floor Area: BELEC 1001 $/Sq.Ft.: ELECTRICAL Architect/Engineer: Elec Svcs 600V <= 200A Valuation: HlEN ERGY Energy BUILDING, BENERGYADD EnergyAddMulti Type of Construction: BINVESTIGA Occupancy Gr up BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Quantity Fee HD Fee Description Fee Group APTFEE EACH STORY OVER 3 HOTELFEE EACH STORY OVER 3 OFFICEFEE EACH STORY OVER 3 BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC 1000 Elec 600V <=1000A ELECTRICAL BELEC 1001 Elec 600V > 1000A ELECTRICAL FZ� BELEC200 . Elec Svcs 600V <= 200A ELECTRICAL HlEN ERGY Energy BUILDING, BENERGYADD EnergyAddMulti BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BNEWMULTI New Multi -family Res ELECTRICAL 1 of 3 �L—� D� C�iZ.e/L 7/S.00 DadZ F00 QZ rn <a FAN Z0PL=FW C X�aV m30 t -=°sHy LU 0 X Ul FZQ ce LU ®® Z 0 ra CA P Z U ®U U CITE' OF CUPEj[tTIN® BUILDING DIVISIONPE �7 C®NTACTOR INFO BUIL1)I8(8A9D1Es9fUGGLE AVE PERMIT NfO 210004 5 OwgAMMHANDRAN , PADMA/ NATARAJ APPLICATI1L�If��17Y 2 0 O 2 �� // PHONE: SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT' PLUMB MECH LICENSED CONTRACTOR'S DECLARATION I hereby affifm that I am licensed under provisions of Chapter 9 (commencing T+y�T.�s REV I S I ON — — I N !1V U JCr>'.��' ONLY with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. ORIG. 402060030, ADD 574 SQ.FT. License Class Lic. p Dale Contractor ARCFIFTECT-S DECLARATION 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License law for the following reason. (Section 7031.5, Business and Professions Cale: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure $70000 prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7000) of Division 3 of the Business and Professions Calc) or 37533062.00 that he is exempt therefrom and the basis for the alleged exemption. Any violation of APN Number Occupancy T p y yl� Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than titre hundred dollars ($soo). 101 — FOUNDATION ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for We (Sec. 7044, Business Professions Code: The Contractor's License Law does not apply 82 — Required Inspections and to an owner of10 3 — UFER property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, 104 — REBAR however, the building or improvement is sold within one year of completion, the owner - builder builder will have the burden of proving that he did not build or improve for purpose of 105 — ANCHOR BOLTS sa1o.). 106 - SEWER & WATER ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to 202 - UNDERFLOOR PLUMBING construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon, and . 203 - UNDERFLOOR MECHANICAL who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. 204 - UNDERFLOOR FRAME ❑ I am exempt under Sec , B & P C for this reason 205 - UNDERFLOOR INSULATION Owner Date 301 - ROUGH PLUMBING WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER I hereby affirm under penalty of perjury one of the following declarations: 303 — ROUGH MECHANICAL ❑Ihave and will maintain aCertificate ofConsent toself-insure for WorkersCompen- cation, as provided for by Section 3700 of the Labor Code, for the performance of the 3O4 — ROUGH ELECTRICAL work for which this permit is issued. 305 - FRAME ❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section 3 O 6 — HOEDOWNS 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Polity number are: 307 — INSULATION Carrier. Policy No.: 308 - SHEETROCK CERTIFICATEO WORKERS' COMPENSATION INSURANCE 309 - EXTERIOR LATH (This section need not be completed ifthe permit is for one hundred dollars (SI00) 310 — INTERIOR LATH or less') 311 — SCRATCH COAT I certify that in the performance of the work for which this permit is issued, 1 shall not 313 - ROOF NAIL employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date 501 - 502 - FINAL ELECTRICAL ENERGY F I NAL PLUMBING ENERGY Applicant NOTICE TO APPLICANT. If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Latex Code, you must forthwith comply with such provisions or this permit shall he deemed revoked. 503 — FINAL MECHANICAL ENERGY 504 - F I NAL BUILDING ENERGY CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of 505 - FINAL ELECTRICAL the work for which this permit is issued (Sec. 3097, Civ. C.) Lenders Name 506 — 507 - GAS TEST F I NAL PLUMBING Lenders Address 1 certify that I have read this application and state that the above information is 508 - F I NAL ME CHAN I CAL correct. 1 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 5 F I NAL GRADE above-mentioned property for inspection purposes 10 FIN I G (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs and expenses which may in any way accrue against said City 5 N LI WORKS in consequence of the granting of this permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCE REGULATIONS. Re -roofs Type of Roof Signature of ApplicanUContractor Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Cafe, Chapter 9.12, and the Health and Safety Calc, Section 25532(a)? ❑Yes [3 No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtainingan inspection, I agree to remove P g Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes ❑ No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Code, Sections 25505, 25533 and 25534.1 understand that if the building does not currently have a tenant, that it is my responsibility to notify the occupant of the requirements which must be met prior to issuance of a Certificate of Occupancy. Signature of Applicant Date All roof coverings to be Class "B" or better Owner or authorized agent Da1C CITY OF cCUPER:1IING CRTY (�) I C I" ER I \ (�) III.�� I I •� I" I" I I( AI I (I) \ IF(I) i". 1 b 62-L)��3�� APN # s �' Date: tt 2 BAPPLOTHER Other Appliances - Building Building Address: Construction Tax BUILDING 18 e-3 7-UC7 Cof EC7f-rvo s o Owner's Name: BCONSTAXBQ Phone #: MS R BCONSTAXH 4,Z3 P- - -2- 2Contractor: Contractor: BCONSTAXR License #: Contact: BELEC 1000 Phone #: Ap c Contra` tor: BELEC 1001 Fax #: Buil ' gP rmit Info: BELEC200 Elec Svcs 600V <= 200A Bldg Elect Plumb Mech scription: BENERGYADD Energy Add Multi Residential: �% BI VESTIGA ercial: Sq.Ft. Floor Area: BMITIGATC $/Sq.Ft.: Architect/Engineer: BMITIGATR Valuation: Type of Construction: BMNEWMULTI Occupancy Group: Quantity Fee RD Fee llDesciri tion Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax - Resi/Mobile BUILDING BELEC 1000 Elec 600V <=1000A ELECTRICAL BELEC 1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL B ENIERGY Eneirgy BUILDING BENERGYADD Energy Add Multi BUILDING BI VESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BNEWMULTI New Multi -family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PL NG 1 of BUILDING DIVISION PER MET J(t �t� ll a A� tui �+ 411jt�Cl�YjiES\ Il �tul� BUILDING ADDRESS: 18891 TUGGLE AVE OWNER'S NAME: RAMACHANDRAN, PADMA/NATARAJAN PHONE: aO O_ ARCHITECTIENGINEER; F U i 6 0. LICENSED CONTRACT'OR'S DECJ,ARATION OZ z - i he§eby affirm that ham licensed under provisions of Chapter9 (commencing QN F to avith'SteegqGn7,q fl) of D[vision 3 of the Business and Professions Code, and my license Y 1 :3i$Jir ftlTTpft>etniaitrieffect. eC C 6 License Class Lie. # CLa UO Date " Contractor O N ARCHITECT'S DECLARATION F — m I understated my plans shall be used as public records "rut.,' p O Licensed Professional OWNER -BUILDER DECLARATION Z} I hereby affirm that I am exempt from the Contractor's License Law for the _ following reason. (Section 7031.5, Business and Professions Code: Any city or county' i Y n which requires a permit to construct, alter, improve, demolish, or repair any structure LU prior to its issuance, also requires the applicant for such permit to fele aligned statement 3 — that he Issticensed pursuhnt to the provisions of the Contractors License Law (Chapter 9 (commencing with Sectio0000)of Division 3 of the Bu;mess and Professions Code) or that he is exempt theiefrom and the basis for the all exemptigp. Any violation of Section 7031.5 by. my applicant for a permit -subjects the applicant to a civil penalty of not -more than five hundred dollars (5500). ❑ 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 and Professions Code: The Contractor's License Law does not apply to an owner of property Who builds or improves thereon, and who does such work himself or through his own employees. provided that such improvements are not intended or offe7red for sale. If, however, the building of iinprovement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for purpose of sale.). at owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contrdcts_for such projetts with a contractors) licensed pursuant.to the Contractors License Law. ❑ f am ex t under Sec - r B & P C for this reason Dt� 0 �.AG3fo� WOR'KER'S COMPENSAt07O1 DEC R ATfON i ®Z Z b DZ U® y b C4] I hereby affirm under penalty,of perjury ode of the following declarations: ❑ I have and win 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 required by Section 3700 of the Labor Code, for the performance of the work for 'which this permit is issued.' My Workers Compensanon Insurance carrier and Policy number are: Carfier. ` ! Policy No.: CERTIFiC 1:1 N OF EXEMPTION FROM WORKERS' . COMPENSATION INSURANCE - (This section need not be completed if the permit is for one hundred dollars ($100) or less.) I certify, that'in the petfo ofthework for which is pe 't is issued, I shall not employ an Berson in an' wooer so as tocp�e bje§t f the,avorkers' Compensation FCalile"' ate "E Applic t NO APPLICANT: If, after making this' ertificate of Exemptipn, you should hec Subject to the Workei s Compensation #bvisions of the Labor Code, you must forthwith cothp(y with such provisions or this permit shall be deemed revoked. -'CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec.' 3097, Civ. C.) Lender's Name Lender's Address I cenlfy- that[ have read this application and state that the.above information is SdiTe6o I agiee:to.cofriply 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 rposes. (We) agree to save, indemnify and keepup harmless the City of Cuperiino against liabilities, judgments, costs and expenses which may in any way accrue against said Ci t consequence the granting of this permit. A��F ICANT STANDS AND WILEVOMPLY. WITH ALL YQ'pOIVT 59LRC R ATIGNS. 01? u O Z� Sign re ofApplicant/Comractor Date HAZARDOUS MATERIALS DISCLOS RE Will the applicant or futuie building occupant store or handle hazardous material as defined by the Cupertino unit' Code. Chapter 9.12. and the Health and Safety Code, Section 75532(a)? 0 Yes o Will the appticant or tore building occupant use equipment or devices which emit hazardous air coniami ants as ed by the Bay Area Air Quality Management District? D Yes No I have ad the hazardous materials requirements under Chapter 6.95 of the Cahfore mia Health & Safety Code, Sections 25505, 25533 and 25534. 1 understand that if the building does not currently have a tenant that it is mysponsibility to notify the oc€upant of th quirements which must be met prior to (ss no of a Certificate of Occupancy. / or authorized agent PERMIT NO. 02060030 APPLICATION SUB DATE 06/05/2002 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB MECH L_7 LJ L_-3 1_-1 Job Description ADDITION AND UPGRADE/REMODEL 37�3�,TTr'.fea. .. ,�.`'. . 101ApN N5ftATION 103 104 105 _106 202 203 204 205 301 302 303 304 305 306 307 30$' 3.0.9 '310 311 '313-, 501 502 " 503 504 505 506 _ 507 508 509 510 514 $70000 - UFER Required Inspections .-. _ REBA R - ANCHOR BOLTS - SEWER & WATER - UNDERFLOOR PLUMBING - UNDERFLOOR MECHANICAL' =- UNDERFLOOR •FRAME - UNDERFLOOR'INSULATION - ROUGH PLUMBING - TUB & OR SHOWER - ROUGH MECHANICAL - ROUGH ELECTRICAL - FRAME - HOLDOWNS - INSULATION SIJEETROCK EXTERIOR LATH' SCRATCH COAT -'ROOF NAIL - FINAL ELECTRICAL ENERGY - FINAL PLUMBING ENERGY- - FINAL MECHANICAL ENERGY FINAL BUILDING ENERGY FINAL ELECTRICAL 7. GAS TEST ; FINAL PLUMBING - FINAL MECHANICAL - FINAL GRADE - FINAL PLANNING it - F INAL ,,PUB161 C WORKS / Issued by: Date Re -roofs Type of Roof . 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 iemove all new materials for inspection. Applicant understands and will comply with all non -point source regulations. 0 ?/ Signature of Applicant Date All roof coverings to be Class "B" or better OFFICE (CIEIIg'ICI+'II(CA'ITE OF CC(GM? LL4N CIE-. R ESM EDTTEAL (Page 1 of 3) CIF -IR I^ OE ala �� 2 Project Title Date /Jwf/ ro6416- *,Ef 1,ferllvg f ' 4w®i� - Projec�s Address Building Ferrol[ � Fri UlrC t9 � ✓_/ 99 ' 0 49 ' Documentation Author Telephone Plan Check / Date er. /Z — Iftorfl,014 4110AC d Field Check / Date Compliance Method (Package or Computer) Climate Zone LniorccrncntAgencv sc v cGIEN ERAIL IMYO IBMA7MN / Total Conditioned Floor Area 1S2!5_ft' Average Ceiling Height: & ft Conditioned Slab Floor Area e5V W Building Type: Single Family j/ Addition (check one or more) Multi -Family Existing -Plus -Addition �I Front Orientation: � North ou East / West / All Orientations �il (�J; (input front orientation in degrees from True North and circle one) I '� goop Number of Stories !i � Number of Dwelling Units: Floor Construction Type: _ (-a Raised Floor (circle one or both) RAllD1IANT BAIL8IIU ER (required in climate Required for this submittal �es no BUI LIIDffNG IENV EILGIM UiSUILA'> HON Component Type Frame Type wd = wood stl = steel Cavity Insulation R -Value Sheathing Total R- Assembly Insulation Value' U -Factor' R -Value Location/Comments (attic, garage, typical, etc.) Wall z i4gtegs- .0 N9 -A Lw Wks war OI?� Fenestration U -Factor Fenestration SHGC n • W Roof Roof Front ` Floor Left Floor Slab Edge Left 'For prescriptive compliance, Total R -Value and Assembly U -Factor are not required for a wood -framed wall that meets cavity R -value insulation requirements for fire Prescriptive Package. FENESTRATION ASO. ALl.80e4. 'a�f S� K �. `7� i Pr r�t�uG—ca CLAI,S cto C, Compliance Forms August 2001 z.}M,5 —i- k -t ?.,'' 'trr P? 'S,l"_ A-2 anaaln z i4gtegs- Fenestration #/T os. Orien- tation Area ftZ Fenestration U -Factor Fenestration SHGC Exterior Shading Att. a s Fins Front Front Left Left Re Wt NtrYQ 3 0.3 0^ ( bYIYMk� Rear(Dow 11 Q 0.ll , 9 STAN19 A)tQV Nh Right(ON064 Right Skylight Skylight ASO. ALl.80e4. 'a�f S� K �. `7� i Pr r�t�uG—ca CLAI,S cto C, Compliance Forms August 2001 z.}M,5 —i- k -t ?.,'' 'trr P? 'S,l"_ A-2 ' (CIEII TII1FE CAT E OF (C®M1?ILL4N CIE-. R ESIDD Eh`TTII�1i IL (]Page 2/of 3) (CIF -IR Project Title Date ' HVAC SYSTEMS Note: Input hydronic or combined hydropic data under Water Heating Systems, except Design Heating Load Distribution Heating Equipment Minimum Type and Duct or Heat Pump Type (furnace, heat Efficiency Location Piping Thermostat Configuration pump, etc.) (AFUE or HSPF) (ducts, attic, etc.) R -Value Type (split or package) D'79 LiAtiS l4-1& SG'(W Cooling Equipment Minimum Duct Heat Pump Type (air conditioner, Efficiency Location Duct Thermostat Configuration heat pump, evap. cooling) (SEER) (attic, etc_) R -Value Type (split or package) SEALED DUCTS and TXVs for Alternative Measures) U Sealed Ducts (all climate zones) (Installer testing and certification and HERS rater field verification required) U TXVs, readily accessible (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater or field verification required) U Refrigerant Charge/Air :Flow (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater or field verification required) OR U Alternative to Sealed Ducts and TXVs (see Package C or D Alternative Package Features for Project Climate Zone) Climate Zone Window SHGC Window U -Factor SEER Heating WATER HEATING SYSTEMS Energy' External Rated' Tank Factor or Tank Water Heater Distribution Number Input (kw Capacity Recovery Standby' Insulation 1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,400 Btuihr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list rated input and recovery efficiencies. SPECIAL IFIEATURIES (add extra sheets if necessary). (Package C and D: TXVs, Sealed Duets, radiant Barriers (see installation requirements for radiant barriers in Section 8.13 of the 2001Residential Manual). (Package C: thermal mass (thermal mass type, covering, thickness, and description). Yiv0- by ;n.(fir,tied IP t`ov9,,Al v 4I4lr evid EVrJ!E G 4 a,�#%,tlo V,(-'11*e^1" v RCeS .'h 4)e --,-Nis a, -id VeGPft,lei"JJP) crt*7-+=i",t. pw tt: Compliance Forms August 2001 A-3 CCIEIIR'IL'1[I RCCA1<'IE OF (COMP LIIAN CIE: I[BIERID Eh` TM L (Page 3 of 3) (CIF -IR �! Project Title Date COMIP I.IT4NC E STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. The undersigned recognize that compliance using duct sealing and TXVs requires installer testing and certification and field verification by an approved HERS rater. IlDe5igner or Owner (per Business and Professions Code) Title/Firm: ,(%y19M Address: f 6q t��� Telephone: <10? • 7,5_3 • zq 15-1; Lic- 4-. /o Z- (srpature) (date) lk EnfoTcemela Title: Agency: Telephone: (signature/ stamp) I(Doe uunneun>tntion Author Name: 6C-14ri C-fi td6 Title/Firm: CYC CA"Ai $ "VC Address: -3� 3 (or rxv Bic a2 PW40W 0-1+ 4055r Telephone: 511 • 36 `F - 6,901 (sign (date) Compliance Forms August 2001 A-4 MANDATORY MIEASURIES CIEIIIECKILI ST: R ESMIEN'l RAIL (Page 1 of 2) MF -IR b Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (*) may be superseded by more stringent compliance requirements Listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or initial applicable boxes when completed or enter N/A if not applicable. DESCRIPTION DESIGNER ENFORCEMENT Building Envelope Measures: ° §150(a): Minimum R-19 ceiling insulation. § 150(b): Loose fill insulation manufacturer's labeled R -Value. ° § 150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -Factor in metal frame walls / does not apply to exterior mass walls). V ° § 150(d): Minimum R-13 raised floor insulation in framed floors. § 1500) : Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no eater than 2.0 pernitinch. §118: Insulation specified or installed meets insulation quality standards. Indicate type and form. § 116-17: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field -fabricated) have label with certified U -Factor, certified Solar Heat Gain Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. § 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. § 150(f): Special infiltration battier installed to comply with § 151 meets Commission quality standards. tv A § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside intake damper I air with and control c. Flue damper and control 2. No continuous burning gas pilot lights allowed. Space Conditioning, Water Heating and ]Plumbing System Measures: §110-§113: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA. 1 §150(i): Setback thermostat on all applicable heating and/or cooling systems. W §1500): Pipe and tank insulation L Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. 2. First 5 feet of pipes closest to water heater tank, non -recirculating systems, insulated (R4 or greater) ^ I� ` V 3. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or R-16 combined internal/external insulation. 4. All buried or exposed piping insulated in recirculating sections of hot water systems. 5. Cooling system piping below 55° F insulated. 6. Piping insulated between heating source and indirect hot water tank. Compliance Forms August 2001 A-5 MANDATORY DA's ORYY lyll IEASUR ES (CIHIIE(CK LIIS T: R ESR DIEN7RA-L (Page 2 of 2) MF -IR Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (°) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be consideredby all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or initial applicable boxes when completed or enter N/A if not applicable. DESCRIPTION DESIGNER ENFORCEMENT Space Conditioning, dater Heating and Plumbing System Measures: (continued) ° § I50(m): Ducts and Fans /V I. All ducts and plenums installed, sealed and insulated to meet the requirement of the 1998 CMC Sections 601, 603, 604, and Standard 6-3; ducts insulated to a minimum installed level of R4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape, aerosol sealant, or other duct -closure system that meets the applicable requirements of UL 181, UL 181 A, or UL 181 B. If mastic or tape is used to seal openings greater than 1/4 inch, the combination ofmastic and either mesh or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and seams of duct systems and their components shall not be sealed with cloth back tubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. 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. 3. Joints and seams of duct systems and their components shall not be sealed with cloth back tubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 4. Exhaust fan systems have back draft or automatic dampers. 5. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 6. Protection of Insulation. 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 e.g., 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 shieldin& from solar radiation that can cause de adation of the material. § 114: Pool and Spa Heating Systems and Equipment. I. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: a. At least 36 of pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. 3. Pool system has directional inlets and a circulation pump time switch. § 115: Gas fired central furnaces, pool heaters, spa heaters or household cooking appliances have no 9a continuously burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) §118(0: Cool Roof material meet specified criteria 2002 Lighting Measures: §150(k)l.: Luminaires for general lighting in kitchens shall have lamps with an efficacy of 40 lumens/wan or greater for general lighting in kitchens. This general lighting shall be controlled by a switch on a readily IIIA accessible lighting control panel at an entrance to the kitchen. § 150(k)2.: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumens/watt or greater switched at the entrance to the room or one of the alternatives to this requirement allowed in § 150(k)2.; and incandescent recessed ceiling fixtures are IC (insulation cover) approved. Compliance Forms August 2001 A-6 vva SIGN ^_ sun nate DIVISION CONTRACTOR INFORMATION: BUILDING ADDRESS: .. _ PERMITNO. NAME: W z O.Ri s LICENSED CONTRACTOR '$ DECLARATION OZ rhandily affirm that fam ficaused under provistious of Chaper,9trommenting ,., Cp i nh ge �qq)90W ofDnti,nW 7- flie Bu -nen and professions Coda, and my license °• O y'U _ License Class Lic. 0 3 a- Data - ..Contractor ARCHITECT'S DECLARATION i > g ,°'..I undetamnd my plans shall be used m public rccoNs til 6 O O Licensed Professional OWNER -BUILDER DECLARATION, I hereby ef5do that 1 nm a con,, from she Cmpmnor s License Law for the F < fallowing reamn. (Section 70I.S. Business and Professions Code: Any city .r county Z G , which requires a permit to constrdcCalmr, improve, demolish, or .,it nay stmctum C r prior toitsissuance,aim acquimtheapplicant forsuch prmiuofile asigned^tnemern d 3 — . .,: h. n n.Ina. i ............ ,...••�:..•......nn. r•...........�. t ._... � .... 11—.— Lot not more than five hundred dollars 0 L' as owner of the property. or my employees with wages as their sale compensation, will do'the 'vo rk: andthe-stmcture is not Intended' or offered for auto ISec: 7044, ^'Busirieinand Professions Code: The Contractor's License Law does not apply to an oner of property Who Wilds or improves thereon, and who does such work himself or through his own employees. provided Nat such improvements ere not intended or -`offered for sok: Ir; hw oever, the Wilding or impldm veem is sold' within' one year of Completion , the owner -Wilder will have the burden of proving that he did not build or improve for pumase of sale.). ..f �ICz��t as rte t Ili .pan, t o Itis sly c (ng wah I'Lelmed contractors m r 4oristruct the pro,ecl (Sat 70 ,'Hti,mmsiand Prokvier, Cade I The Contractors License Law,dues m apply to an owner of property who builds or improves thereon, and who, com icts,for, such. profess witha. contmnor(s) licensed pursmnt,to the CalculationsLicense La Ola - funder Secj — - ° B&P C for thisrcmn 0.7' 1"4W0` WORKER'S COMPENS710N DEC ARATION Ihereby affirm under penalty,of perury tui, fine f II ing dedhotoin sry 0 1 have "ond'will t ni n'u Cao name of Cnnsem to If insure for Workers Compensation, us, provided far by Section 3700 of the Labor Code, for the - _ - pertonnance df the work for which mis.permil is issued. . 01 have'and will maintiin Woikei E Compeb'seilnn'Insumncc, as required by genion 37W of Ne labor Code, for the peHomtence of the work for which this p4mout is iss ed My W k Y Compenset on 1 uller and Policy n mbe no: Carts r ' S 0i ' I 1 'i Policy NAL il, CFKlI11CATIONOPE' EMPTION FROM WORKERS n , I COMPENSATION INSURANCE— trisection nceL m� be compleieJ if the permit is for one hundred dollars „ (SlWlmor less.) ; y with such previsions or this permit &hall be deemed revoked. ` I CONSTRUCTION LENDING AGENCY ` t ILL of nii that there is'. construction lending agency for the perfnmsdnce' which this permit is loved (Sar'3097, Civ. C.) r' r,:tl.,Lt.-f.1 t:':,.., that I h e read th"s appl nt nd. sate that the above Informal ion is tit -comply th', olfeity.a it countyordinances d stare laws relating tinction,and hereby twtipnze mIniammmives ofthtvcity center upon Lined property for inspection purposes.,,, ee m save, indemnify and keep harmless the City of Copeninb'against scnts, costs and expenses which may in any w� accrue crue against said tie dhb: ol.niino nh6:...:6.n � • atY PP n 9 t - t fillt -u't t WII th appl cA]\RUOre b'\Iding tµANlurt hoPS n le hazardoust tn'I ps Jef ed by th C peryn9 Code Ch pmr91 dth Healthu ISafety Cede SOecm 25573( 1, I , s1 W II th yes . am or mrt Wilding ac p nt use eq ipmcn, or device which emit hazard omaml ants a od by theB y Area Ail Qml ty Management D t n /jNa—C"Tn�' t 1 M1 e Health & Se hex dons mann Is req 25533 a under 4, pt understand f the C hf m a H Ith & $ fety Code Sections 25505 I I and 25534 Fundenu d that tf th bddmg tloesnt trendy haveet ria tthmiW my spices bltymnoufy the ac pant of th qu.ements wh¢h musnbe ren p or ro t n of a Cenificarc of r •. 01 Y'' ,PPLICATION SUB DATE 06/05/2002 BLDG ELECT PLUMB MECH Job Description _• . ADDITION AND-UUPGRADDE•/REMODEL'- FINAL ED FEB 2 7 2003 El ING, '..' $70000 F6�,A�f Valw r S'3+3t ., j`r 101" V8ftATION Occupt 103 - UFER Required Inspections" -----'---__----_--------------------- 105 - ANCHOR BOLTS 106 - SEWER & WAT_ER 202 UNDERFLOOR PLUMBING ,' c 203 - UNDERFLOOR MECHANICAL` ' .-2047--- UNDERFLOOR'_- FRAME_- 205 UNDERFLOOR'INSULATION- 301 ROUGH --PLUMBING•`` 302 - TUB & OR SHOWER 303 - ROUGH MECHANICAL' 304 - ROUGH ELECTRICAL 305 - FRAME 306 - HOLDOWNS 307, - INSULATION, '` I 30'9 ` "EXTERIORO-'LATH' 31'0:;'=•. INTERIOR 'LATH , ;, :'k: , . + ,:• 311 - SCRATCH COAT 313,.,_.:.ROOFNAI=L-a„+..•:.•:.:„:,n 501 - FINAL ELECTRICAli'ENERGY 502- --FINAL 503 FINAL MECHANICAL'ENERGY .. _.._......504- __F.INAL-BUILDING-ENERGY..-----.__.._.___-.....__...._.. 505 - FINAL ELECTRICAL,.,, 506,=, -,GAS TEST ....._ _.....__...._.._.... _... -- -..._. 507 - FINAL PLUMBING,,r,t.,,,., 508 - FINAL MECHANICAL,,, 509 - FINAL GRADE 510 - FINAL PLANNING 514 n FINAL U C WORKS J Issued by: Date Re -roofs Y, • -T'pe of Roof. _..� _.,..,_. All roofs shall be Inspected poor to any-rooffng,matenal being installed.__ If a roof Is installed without first obtaining an inspection I'agree toremove allnew materials for inspection Applicant understands and will comply with ,.._. 511 non -point source`[egulahons h Signature of Applicant Date All roof coverin s to be Class `rB" or better .agent j.,L f, Date l 9 a I. OFFICE'.__ ..., ..:_... ..__.... ....