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15060003no CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7717 OAK MEADOW CT CONTRACTOR: LUO SITYH-CHERNG PERMIT NO: 15060003 AND WANG HSN-HUI OWNER'S NAME: LUO SITYH-CHERNG AND WANG HSIU-HUI 7717 OAK MEADOW CT DATE ISSUED: 11/24/2015 OWNER'S PHONE: 4083076103 CUPERTINO, CA 95014-5201 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 1ST FLR ONLY - REMODEL (E) ENTRY & LIVING RM License Class Lic.# AREA (500 S.F.). RAISE CEILING HEIGHT IN GARAGE & Contractor Date LIVING RM FROM 8' TO 14'6" MAX (SLOPED), RE -ROOF 1 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 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 Sq. Ft Floor Area: Valuation: $50000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 36626006.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the U granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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. (l Yui Ac OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of e following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER owner of the property, or my employees with wages as their sole compensation. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous Rclarations: ave and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous mpensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and -state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signatttr Date F�- i &6 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15060003 7717 OAK MEADOW CT CUPERTINO CA 95014 (366 26 006) OWNER BUILDER OWNER'S NAME: LUO SITYH-CHERNG AND WANG HSN-HUI DATE ISSUED: 11/24/2015 OWNER'S PHONE: (408) 307-6103 PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INF;l�'�Io� �® License Class LIC. # Contractor OWNER BUILDER Date — 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: 1 ST FLR ONLY - REMODEL (E) ENTRY & LIVING RM AREA (500 I hereby affirm under penalty of perjury one of the following two declarations: S.F.). RAISE CEILING HEIGHT IN GARAGE & LIVING RM FROM 8' 1. I have and will maintain a certificate of consent to self-insure for Worker's TO 14'6" MAX (SLOPED), RE-ROOF Compensation, as provided for by Section 3700 of the Labor Code, for the 24 SQ'S performance of the work for which this permit is issued. z. I have and will maintain Worker's Compensation Insurance, as provided for by REV #1 - CHANGE DESIGN OF FRONT PORCH AND ENTRANCE; Section 3700 of the Labor Code, for the performance of the work for which this CHANGE ROOF MATERIAL - ISSUED 10/27/2016 permit is issued. Sq. Ft Floor Area: Valuation: $50000.00 APPLICANT CERTIFICATION I 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 366 26 006 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 10.27.16 Issued by: SEAN HATCH Date: 11/24/2015 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is r. caner 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 ensation, will do the work, and the structure is not intended or offered for F inspection. Sec.7044, Business & Professions Code) p I, as owner of the property, am exclusively contracting with licensed Signature of Applicant / contractors to construct the project (Sec.7044, Business & Professions Code). Date: 10.27.16 I hereby affirm under penalty of perjury one of the following three declarations: ave and will maintain a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Labor Code, I must forthwith comply with such provisions or this permit shall the Health & Safety Code, Sections 25505, 25533, and 25534. be deemed revoked. i a Owner or authorized agent: APPLICANT CERTIFICATION Date: 10.27.16 certify that I have read this application and state that the above information is D GAGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Signature '� Date 10.27.16 Licensed Professional &6 �Leu4 j CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUFERTfNO 1 (408) 777-3228 • FAX (408) 777-3333 • buildin c Dertino.or ❑ 1\TEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TIVISION DEFERRED 15 0�, 0003 ORIGINAL PERMIT' PROJECT.4DDRE55 � n b� K �Q , J G � A.PN r V V OWNER NA%IE PHO. va a G/ E,144ILVVa� C/ Y_ V1 L O STREETADDRESS�1 n v \ C / I CITY, STATE, IPS /� fA ii p 6A vl (� CONTACT N? \4E I P \t ^ E- i47L - n STREET ADDRESSD� C ITY, S�4TE, IP ,rlv �� cis Heod FAX ❑ O'ANER OwNtR-BI--DER ❑ OW-KERACENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ P.RCHITECT ❑ ENG-INEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # JAy COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEERN.4'"E LICENSE NI A4BER BU'S. LIC .P Sl dt- cQ_ _ b -Sc Al2L- � . COMPANYNAME %I dal n� Q(�� r E-MAIL _ FAX STREET.ADDRESS 2iq �N CIT, STATE, PJan JC� lIL ' 11P27 Ly o DESCRIPTION OF WORK e d� un a .� S e. �� o,�. w o� E � w C�tti.�.►2q e S �� � �.,c Yea �._ LIP S C' Z) ur Q„1an c2. Dina ��o o }-o✓c�, Zso re ro,, 23 �� • - EXISTING USE PROPOSED USE CONSTR T]TE resp, G�JS ;: STORIES 2 USE TYPE OCC. SQ.FT. VALUATION (S) AREA 7 a � j�J NEWFLOOR L ' t DAR.EAO /- J /�. NTETTAREA) 61 tr e_ BAIMOOM REMODEL AREA (J / KITCHEN REMODELAREA k OTHER M40DELAREA PORCH AREA 20 -i -,4c, DECIuAREA�y 1 l.� - 1'� TOTALS LDECK?O'RCH AREA �l 10 J GARAGE AREA: DETACH 3 , _ �_j + TTACH DwELLD:'G L" TTS: IS A SECOND L'NITYES BEnvG ADDED? WO SECOND STORY ]'ES ADDITION? 0 PRE -APPLICATION Rb -ES 7YES, PROVIDE COPY OF IS THE BLDG AN ❑YES REC ED BY: TOTAL VA TION: PLA\-NNhGAPPLr ❑NO PL4\T`L-GAPPROVAL LETTER EICHLERHO.NIE? R!:O By my signature below, I certify to each of the following: I am the property owner or authorized agent to Nct 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 \T WI< and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection/purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFOR247MTON REQUIRED I PLAN CHECK TYPE ` - ROUTING SLIP ' n ON i H rl:£-coCNTEI: � rrILVINc I L:1\ I \ !E\\' New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ E\I'RFSS - ❑ PLANNING PLAN REVIEW Bldgs: Provide a completed Hazardous Materials Disclosure C STA�'-va;:v - PCI3LIC n 0T,KS _Commercial fonn if any Hazardous Materials are being used as part of this project. ❑..: iJ LARGE FIFE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ ❑ s.�NiT.4R] sE\3 ER nlsTlucT submittal of Building Permit application. .\taroR . EN\-IRONMENTAL HEALTH BldgApp_2011.doc revised 06121/11 1 /t7n\ CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • building(cr�cupertino.org N= 5000003 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / Ti El REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS j Ci CT APN n 3 6 2 6- 6 ;,) /- ` L4� ))0--1, OWNER NA (-v/II� HONEQt-. 1 / ' �� P6�0+ 'G E-MAIL L c :J STREET ADDRESS -7CITY, 9/ OA k N14 VCyJ GT . STATE, ZIP FAX c y �i17�t! e- C 4 V I CONTACT NAME G 1 �� I l^ f �l� PHONE V t 1 �3 S'7 C Z /`W (�- E-MAIL C� } i- STREET ADDRESS 21 13 CJ Mr,(% Pi CITY, STATE, ZIP � ��ll � C� f � (jS122 (❑ FAX OWNER ❑ OWNER --BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORJ!AME LICENSENUMBER LICENSETYPE BUS. LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME ICELoNS NUMBER BUS. LIC # a f COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP P ugh W3 T 2-Y DESCRIPTION OF WORK �S �' (� V � ✓.'�� Y �^ V\ Li C�-� � L r -'A1S e CSI I nG �rZt �}- 1 n �� f -t U.J�►n ' Ic-C�� fiOM D 1 'tom 1 `[' \ t. iVlo e EXISTING USE PROPOSED USE CONSTR TYPE 4 S RIES - USE TYPE OCC. SQ.FT. VALUATION (S) E>aSTG - NEW FLOOR- DEMO TOTAL AREA AREA AREA NET AREA - BATHROOM REMODEL AREA KITCHEN. REMODEL AREA OTHER C REMODEL AREA v'O S� J t - PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH 9 DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY OYES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES D BY _ '' - TOTAL VALUATION: PLA.NNTNG ADPL r ❑ NO PLANNING APPROVAL LETTER EICHLER HOMED ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized ae n t Ope er's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work verify it is . I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above- identified property for inspection purposes. 1 S Signature of Applicant/Agent: , Date: l SUPPLEMENTAL INFORMATION REQUIRED PiaxcBECKT3PE _., zovTmc"sL>P ovERTJcounTER BvuDu1GPLANItEVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. a EXPSiES$ +-� Sit- D PLAN'RL�GPLANREVIEW -: _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ©sTAlvnaRD ❑ PUBLIcoRxs `sem 'T 4 form if any Hazardous Materials are being used as part of this project. LARGE�� � �.rF.iFIEDEPT3 s ���.. Copy of Planning Approval Letter or Meeting with Planning prior to �❑ _ � } � ��� t r+ _ submittal of Building Permit application. MA70R:T i �.: a L�-SAI�rI`ARYSEWERDIST'RICT' _ B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, Fire, 3anuary,3ewer "Wreci, .knout r.:...-:... .... TG,...,. r „� ,..e 6..�od m the nrefiminan, infarmatinn availahle and are only an estimate. Contact the Dept for addn'l info. - ccu u•t ✓uu�.0 v.• ..... ...........». Ills/r lc., Cll.. . 1/I1—all” FEE ITEMS (bee Resolution 11-053 Eff: 7i1i13) ADDRESS: 7717 OAK MEADOW CT DATE: 06/01/2015 REVIEWED BY: MELISSA [�>i•„- APN: 366 26 006 BP#: `VALUATION: $50,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex p trub. hasp. Fc, PENTAMATION 1GENRES PERMIT TYPE: USE. PME Plan Check: $0.00 WORK 1ST FLR ONLY- REMODEL E ENTRY & LIVING RM AREA 500 S.F.. RAISE CEILING HEIGHT IN SCOPE GARAGE & LIVING RM FROM 8' TO 14'6" MAX (SLOPED) NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, Fire, 3anuary,3ewer "Wreci, .knout r.:...-:... .... TG,...,. r „� ,..e 6..�od m the nrefiminan, infarmatinn availahle and are only an estimate. Contact the Dept for addn'l info. - ccu u•t ✓uu�.0 v.• ..... ...........». Ills/r lc., Cll.. . 1/I1—all” FEE ITEMS (bee Resolution 11-053 Eff: 7i1i13) ifech. flan Check I'hurrh. flan Check I.Jec. Plan Ciwek [�>i•„- Plumb. Permit Fo'. Flee. Permit Fee tliia�r tie:ch, i,rsf,_ er Plumb InsT.�rer -le Insp t,tech. Insp. Fee: trub. hasp. Fc, fy V� E NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, Fire, 3anuary,3ewer "Wreci, .knout r.:...-:... .... TG,...,. r „� ,..e 6..�od m the nrefiminan, infarmatinn availahle and are only an estimate. Contact the Dept for addn'l info. - ccu u•t ✓uu�.0 v.• ..... ...........». Ills/r lc., Cll.. . 1/I1—all” FEE ITEMS (bee Resolution 11-053 Eff: 7i1i13) _. __. FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Yes Q No $0.00 hours $286.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 500 I s.f. $503.00 Remodel, Other IREMRESOTH Permit Fee: Hourly Only? ()Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: F71 Administrative F(?e' Work Without Permit? O Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure 1'raivi Doculnc'nlallun 1"ces: Strong, Motion Fee: IBSEISMICR $6.50 2.0 hrs $286.00 Inspections ISTINSP Inspection, Hourly Bldg* Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $8.50 $1,075.00 TOTAL FEE:$1,083.50 Revised: 05/07/2015 OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildingQcuDertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS 7W AP�N 3 >6 - OWNER .L OWNER ADDRESS - c� cBaP#�eAk—m�wwCr DESCRIPTION OF WORK: �' i7♦rb N !11 � � ��'Of We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- uilder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. understand building permits are not required to be signed by property owners unless they are responsiblb for construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may ect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license tiers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the to value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. I understand if I am considered an "employer" under state and federal law, I must register with the state and ral government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family idential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for y financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderFonn 2010.doc revised 04/14/10 understand I may obtain more information regarding my obligations as an "employer" from the Internal enue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I he party legally and financially responsible for proposed construction activity at the site address listed above. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide �!]:I'lapplicable laws and requirements that govern Owner -Builders as well as employers. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the i mation I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint, Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on,your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: - -------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForm 2010.doc revised 04/14/10 CUPERTINO PURPOSE: CALGREEN RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPEFijin;cut Copy (408)777-3228- FAX (408)777-0 CnE 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: LUO REMODELING Project Address: 7717 OAK MEADOW CT Project Description: 500sq ft REMODELING - CHANGE OF ROOF @ FRONT AREA, NEW SLOPED CLG' @ LIVING - NEW ENTRY, FRONT PQRQH RF=pELING. NO SQ.FT. ADDITION, RE -ROOF OF 2380 Si' 0 f i%I 11 1AL Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced he California Green Building Standards Codes to verify and assure that all required work describ erein 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, sid date Section 1 - Design Verification at the end of this checklist and have the cR=.for the project. checklist printed on m3. Prior to final inspection by thbepartment, 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 Requirements Planning and Design - Site Development 4.106.2 Storm water drainage and ret ti during construction. A plan is developed and implemented to manage storm \ter drainage during Q ❑ construction. 4.106.3 Grading and paving. The site hall 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. Pagel of 5 CalGreen_2014.doc revised 11104/14 I .2 ENERGY EFFICIENCY General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. .. .3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following: ❑ 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank -type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank -type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen_2014.doc revised 11/04/14 Outdoor Water Use 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather -based. ❑ 4.304.1.1 Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ 4.304.1.2 Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. A4.4 MATERIAL 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. .. .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 Q■ distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic Q compounds. Page 3 of 5 CalGreen_2014.doc revised 11/04/14 4.504.2.4 Verification. Documentation shall be provided to verify that ❑ compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with ❑ VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHPS) Low -emitting ❑■ ❑ Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall ❑■ ❑ comply with low formaldehyde emission standards. Interior Moisture Control 4.505.2 Concrete slab foundation. Required vapor retarders and capillary ❑ breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building E]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 El 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 sysiem installers are trained and certified in ❑ ❑ the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the ❑ ❑ discipline they inspect and verify. Verifications 703.1 Documentation. Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection reports, or other methods acceptable to the enforcing ❑ agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 CalGreen_2014.doc revised 11104114 Project Name: Project Address: CALGREEN SIGNATURE DECLARATIONS LUO REMODELING 7717 OAK MEADOW CT Project Description: 500sq ft REMODELING - CHANGE OF ROOF @ FRONT AREA, NEW SLOPED CLG' @ LIVING - NEW ENTRY, FRONT PORCH REMODELIN NO SQ.FT. ADDITION, RE -ROOF OF 2380 SQ.FT. 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. �K-crt7rRj��(, L") o Owner's Signature Owner's Name ase Print) �l Design Professional's Signature ( al � l � ro�, u,", a.— Design Professional's Name (Please Print) Sign ure of License Professional responsible for CalGreen compliance Name of License Prdfessional rdsponsible for CalGreen compliance (Please Print) Emajl Address fors License PRfessional responsible for CalGreen compliance l � f SECTION 2 — IMPLEMENTATION VERIFICATION Date 1)- ( 0-- lam Date )-10- (�- Date LAV -3 -4637 ZS? Phone Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2014.doc revised 11/04/14 BUILDING ENERGY ANALYSIS REPORT I OFFICE COPY PROJECT: New Roof 7717 Oak Meadow Ct Cupertino, CA 95014 Project Designer: RECEIVED D Square Studio SUBMITTAL BY Report Prepared by: Frank V. le TITLE24.NET 14211 Riata Street Westminster, CA 92683 714-600-7955 C4 BEC CERTIFIED ENERGY ANALYST Job Number: 86-05 Date: 8/9/2015 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2013 Building Energy Efficiency Standards. IThis program developed by EnergySoft, LLC — www.energysoft.com. Ener Pro 6.7 by Ener Soft User Number: 5985 ID: 86-05 V I TABLE OF CONTENTS I Cover Page Table of Contents Form CF -1 R -ALT -05-E Certificate of Compliance Form RMS -1 Residential Measures Summary EnergyPro 6.7 by EnergySoft Job Number. ID: 86-05 User Number: 5985 1 2 3 11 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1R-ALT-05-E Revised 01/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 1 of 8) Project Name: New Roof I Date Prepared: 8/9/2015 I This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CF1R-ALT-01 shall first be registered with a HERS Provider Data Registry. Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-ALT-05 and CF2R-ALT-05 Compliance Documents. Possible exemptions from duct leakage testing include: less than 40 ft of ducts were added or replaced; or the existing duct system was insulated with asbestos, or the existing duct system was previously tested and passed by a HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CFIR-ALT-02 must be completed and registered with a HERS Provider Data Registry. Alterations that utilize Closed Cell Spray Polyurethane Foam (ccSPF) with a density of 1.5 to less than 2.5 pounds per cubic foot having an R -value other than 5.8 per inch, or Open Cell Spray Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having an R -value of 3.6 per inch, shall complete and register a CF1R-ALT-01 with a HERS Provider Data Registry. If more than one person has responsibility for installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible. Alternatively, the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures shall be met. Temporary labels shall not be removed before verification by the building inspector. A. GENERAL INFORMATION 01 Project Name: New Roof 02 Date Prepared: 8/9/2015 03 Project Location: 7717 Oak Meadow Ct 04 Building Front Orientation (deg or cardinal): (S) 180 deg 05 CA City: Cupertino 06 Number of Altered Dwelling Units: 1 07 Zip Code: 95014 08 Fuel Type: Natural Gas 09 Climate Zone: 4 10 Total Conditioned Floor Area (ft 2): 2,784.0 11 Building Type Single Family 12 Slab Area (ft) 1,884 13 Project Scope: Alteration CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1 R -ALT -05-E Revised 01/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 2 of 8) Project Name: New Roof I Date Prepared: 8/9/2015 I B. BUILDING INSULATION DETAILS (Section 150.2(b)1) 01 02 03 04 05 06 07 08 1 09 10 11 Tag/ID Assembly Type Frame Type Frame Depth (inches) Frame Spacing (inches) Proposed Required Comments Cavity R -value Continuous Insulation R -value U -factor Appendix JA4Reference LI -Factor Table Cell 1 Roof Wood 2x4 @ 24 in. O.C. 30 0.0 0.031 4.2.1-A20 0.031 R-30 Roof Attic CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1 R -ALT -05-E Revised 01/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 3 of 8) Project Name: New Roof Date Prepared: 8/9/2015 C. ROOF REPLACEMENT (Prescriptive Alteration, Section 150.2(b)1H) 01 02 03 04 05 06 07 08 09 10 11 12 13 Method of Compliance Roof Pitch Exception CRRC Product ID Number Product Type R -value Deck Insulation Proposed Minimum Required Initial Solar Reflectance Aged Solar Reflectance Thermal Emittance SRI (Optional) Aged Solar Reflectance Thermal Emittance SRI (Optional) Existing Fenestration Fenestration Allowed Fenestration West Facing Maximum Maximum Maximum Maximum Alteration West -Facing Allowed Allowed Allowed Allowed Area For All Area For All Area for All Fenestration Comments Type Fenestration U -factor U -factor SHGC SHGC Orientations (ft2) Orientations (ft 2) Area Only Orientations (ft2) Area (ftZ) (Windows) (Skylights) (Windows) (Skylights) (ft) (Windows) (Skylights) Add75 I n/a n/a n/a 1 266.8 58.0 0.32 _J__0.32 0.25 0.25 <= 75 sgft of windows added NOTES • Roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1) 01 02 03 04 05 06 07 Maximum Maximum Allowed Allowed Maximum Existing Existing Fenestration Fenestration Allowed Fenestration West Facing Maximum Maximum Maximum Maximum Alteration West -Facing Allowed Allowed Allowed Allowed Area For All Area For All Area for All Fenestration Comments Type Fenestration U -factor U -factor SHGC SHGC Orientations (ft2) Orientations (ft 2) Area Only Orientations (ft2) Area (ftZ) (Windows) (Skylights) (Windows) (Skylights) (ft) (Windows) (Skylights) Add75 I n/a n/a n/a 1 266.8 58.0 0.32 _J__0.32 0.25 0.25 <= 75 sgft of windows added CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification �l. CEC-CFIR-ALT-05-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION '":W CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 4 of 8) Project Name: New Roof E. FENESTRATION PROPOSED AREAS AND EFFICIENCIES — Add (Section 150.2(b)lA) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Tag/ID Fenestration Type Frame Type Dynamic Glazing Orientation N, S, W, E Number of Panes Proposed Fenestration Area (ft) Proposed West Facing Fenestration Area (ft) U -factor Source SHGC Source Exterior Shading Device Combined SHGC from CFIR-ENV- 03 1 New Non -Metal (S) 60.0 0.290 NFRC 0.25 NFRC 0.25 2 New Metal Roof 8.0 8.0 0.290 NFRC 0.25 NFRC 0.25 15 Existing + Proposed Fenestration Area 334.8 16 Maximum Allowed Fenestration Area no limit 17 Compliance Statement Is the Existing + Proposed Fenestration Area <_ the Maximum Allowed Fenestration Area ® Yes ❑ No 18 Existing + Proposed West -Facing Fenestration Area 66.0 19 Maximum Allowed West Fenestration Area no limit 20 Compliance Statement Is the Existing + Proposed West -Facing Fenestration Area <_ he Maximum Allowed West Fenestration Area m Yes ❑ No 21 Proposed Fenestration U -factor (Windows) 0.290 22 Required Fenestration U -factor (Windows) 0.320 23 Compliance Statement Is the Proposed Fenestration LI -factor <_ the Required Fenestration U -factor 0 Yes ❑ No 24 Proposed Fenestration SHGC (Windows) 0.250 25 Required Fenestration SHGC (Windows) 0.250 26 Compliance Statement Is the Proposed Fenestration SHGC <_ the Required Fenestration SHGC is Yes ❑ No 27 Proposed Fenestration U -factor (Skylights) 0.290 28 Required Fenestration U -factor (Skylights) 0.320 29 Compliance Statement Is the Proposed Fenestration U -factor 5 the Required Fenestration U -factor la Yes ❑ No 30 Proposed Fenestration SHGC (Skylights) 0.250 31 Required Fenestration SHGC (Skylights) 0.250 32 Compliance Statement Is the Proposed Fenestration SHGC <_ the Required Fenestration SHGC Q Yes ❑ No CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CFIR-ALT-05-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 5 of 8) Project Name: New Roof I8MU19 I F. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES — Replace (Section 150.2(b)iB) 01 02 03 04 05 06 07 08 9 10 it 12 13 14 Tag/ ID Fenestration Type Frame Type Dynamic Glazing Orientation N, S, W, E Area Removed (ft') Area Added (ft) Net Added Area (ft) U -factor Source SHGC Source Exterior Shading Device Combined SHGC from CFIR-ENV-03 15 Net Added West -facing Fenestration Area n/a 16 Existing + Added West -facing Fenestration Area n/a 17 Maximum Allowed West -facing Fenestration Area n/a 18 Is West -facing Fenestration Area < Maximum Allowed West -facing Fenestration Area 0 Yes ❑ No 19 Net Added Fenestration Area (all orientations) 68.0 20 Existing + Added Fenestration Area (all orientations) 334.8 21 Maximum Allowed Fenestration Area (all orientations) n/a 22 Is Existing + Added Fenestration Area < Maximum Allowed Fenestration Area (all orientations) ® Yes ❑ No CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1 R -ALT -05-E Revised 01/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 6 of 8) Project Name: New Roof Date Prepared: 8/9/2015 G. SPACE CONDITIONING (SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b)) Alterations to Space Conditioning Systems shall be exempt from HERS verification requirements as prerequisite for use of the CF1R-ALT-05 and CF2R- ALT -05 Compliance Documents. If new space conditioning systems are installed or existing systems are altered and are not exempt from HERS verification, then a MR -ALT -01 shall be completed and registered with a HERS Provider Data Registry. In each row below for each dwelling unit in the building, check the box that indicates the exemption from HERS verification compliance: ❑ a: space conditioning system was not altered; ❑ b: less than 40 ft of ducts were added or replaced; ❑ c: (exempt from duct leakage testing) if: the existing duct system was insulated with asbestos; ❑ d: (exempt from duct leakage testing) if: the existing duct system was previously tested and passed by a HERS Rater. 01 02 03 04 Dwelling Unit Name SC System Identification or Name SC System Location or Area Served Exemption from HERS Verification House HVAC System 2,784 ❑ a El b ❑ c ❑ d HVAC System 2,784 Q a E b ❑ c ❑ d 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 El CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CFIR-ALT-05-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 7 of 8) Project Name: New Roof I Date Prepared: 8/9/2015 I H. WATER HEATING SYSTEMS (Section 150.2(b)1G) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 Dwelling Unit Name Water Heating System Identification or Name Water Heating System Location or Area Served Water Heating System Type Water Heater Type tt of Water Heaters in System Water Heater Storage Volume (gal) Fuel Type Rated Input Type Rated Input Value Heating Efficiency Type Heating Efficiency Value Standby Loss (%) Exterior Insulation R -Value Back -Up Solar Savings Fraction CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1 R -ALT -05-E Revised 01/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification (Page 8 of 8) Project Name: New Roof I Date Prepared: 8/9/2015 I DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Frank V. le Documentation Author Signature: Company: TITLE24.NET Signature Date: 8/9/2015 _ Address: CEA/ HERS Certification Identification (if applicable): CAB C 14211 Riata Street aaE City/State/Zip: Westminster, CA 92683 Phone: 714-600-7955 °°°�°°°•°R°°° °°° RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: C� ( Responsible Designer Si nature: 11� L /-\(A'4�' Company: q D Square Studio Date Signed: I Address: 2��3 5�����, fin. License: City/State/Zip: 5 ^ ' � � � ' t ,`J Phone: Ll o r �� l0 3 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 RESIDENTIAL MEASURES SUMMARY RMS -1 Project Name New Roof Building Type m Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 8/9/2015 Project Address 7717 Oak Meadow Ct Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 2,764 Addition n/a # of Units 1 INSULATION Construction Type Area Cavity (ft) Special Features Status Wall Wood Framed R 13 2,297 Existing Roof Wood Framed Attic R 30 2,092 New Slab Unheated Slab -on -Grade - no insulation 1,884 Perim = 186' Existing Floor Wood Framed w/Crawl Space R 19 750 Existing FENESTRATION I Total Area: 335 Glazing Percentage: 12.0%1 New/Altered Average U -Factor: 0.29 Orientation Area(ft) U -Fac SHGC Overhang Sidefins Exterior Shades Status Front (S) 60.0 0.290 0.25 none none Bug Screen New Left (w) 58.0 0.550 0.67 none none Bug Screen Existing Rear (N) 134.4 0.550 0.67 none none Bug Screen Existing Right (E) 74.4 0.550 0.67 none none Bug Screen Existing Skylight 8.0 0.290 0.25 none none None New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 80% AFUE No Cooling 13.0 SEER Setback Existing HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status HVAC System Ducted Ducted Attic 4.2 Existing WATER HEATING Qty. Type Gallons Min. Eff Distribution Status Ener Pro 6.7 by Ener&qySoft User Number: 5985 RunCode: 2015-08-09T16:12:26 ID: 86-05 Pae 11 of 11