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14110062-DCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19501 STEVENS CREEK BLVD STE 102 CONTRACTOR:'9'8' `F0 BE QE1FJ"4WE44_ PERMIT NO: 14110062 OWNER'S NAME: NOBLE BROHTERS LLC aA�rr DATE ISSUED: 02/25/2015 OWNER'S PHONE: 6505150880 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL CREAM- COMM. TJ TO EXISTING BLDG 1273 SQ FT License Clas Li,. # Alz �� e^� Contractor 3At�}i f3 Q; f J,,, i5 Date 2 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 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: $65000 erformance of the work for which this permit is issued. 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 APN Number: 31649110.102 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 18 S 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 DAYS7 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 granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -point source regulations he Cupertino Municipal Code, Section 9.18. Signature Date RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 sale (Sec.7044, Business & Professions Code) 1, 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. 1 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 declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, 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 Munici al Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505 2 , an 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 2 ' Z j/. 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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.I8. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 14081777-3228 - FAX (408) 777-3333 - buildincO)curiertino orn CUPERTINO I ❑ NEW CONSTRUCTION ❑ AwrriON ALTERATION / TI [:] REVISION DEFERRED ORIG[NAL PERMIT # PROJECTADDRESS ( )L, [CAVIO-i'R NANiF YNLILVIIN Ltukll NIONF ,�-✓ UYA 6�n Is- -) Z SIRi--FrADDRESS CI['Y,S'rA'IL,ZII' CONI'ACI NAME '0MU3ANI I F -MAIL, 'k, - ow SIRI-177ADDRESS" crr Y. s rE. zu) C kll"', i K I Y I'l, s S I IJRILA ❑ OWNER ❑ OWNER-BULDI-14 ❑ 0,F E, R A G I-.- NT ❑ CONrRACIOR El CoNFRACrOR A(jl,:,,N I ARCHITECI ❑ LNGINFIF-R ❑ DEVELOITR TENANT CONTRACT -OR NAMF 1-10- ISE NUMBER [AC1--,NSE'TYpr [31;S 1-1c, CONIPANY NAME, E-MAIL FAX SIRE -1--] M)IJKPFS 'IT), STAT f- ZIP Pi WNE' VRF A I1PI K X rION [D)TS IF )IF." RRO"m- covy or �FlItHI-I)c ��k, 0 YI-5 131.5 1AC IT CONIPANY NAME- A NSQCJ ATS, 71-11,-111-wx�on �t3n,lnc FAX 1 SrRLEFAODIZESS)(A�J: r4 V -K # I'J" (11-�-SIWIT,13P 60 _) Ck\)�ft , V1 UV(N[,) CA ')2 L� DF�i('RIVTION OF WORK vyio(-i&O r4 4(u W� ,, �,,c Q. ItAm \(-Q (-((,(-ki-n Lxis riNc) usE PROPOSIJ) USE C kll"', i K I Y I'l, s S I IJRILA US F FY TE o(,( SQ.] -,-r VALUA rfON BEING AIMEW Ii7No kVY) VRF A I1PI K X rION [D)TS IF )IF." RRO"m- covy or �FlItHI-I)c ��k, 0 YI-5 CX�S'M 0 I'Al. VALLIA1 I ON' PLANNING API'l. 'I [] NO PLANNING MrA ' NF AR f.,\ 30o o0 By my signature below, I certify to each of the following: I am the property owner or authorized agent to M A`the pmpIty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. A ordinances and state laws relating to building construction I authorize representatives ot'Cupertino to enter the above -identified property for inspection purposes SiV,natUl"C of'ApplicanuAgent Date: WPI'LLMENTAL INFORMATION REQUIRED PLANCHECKTITE ROUTING SIAJI BAIUROOM OT14FR DEL New SFD or Multifamily dwellings: Apply for demolition permit tbr existing building(-,). Demolition permit is required prior to issuance ol"building Ft ENIODFLARFA AREA M AREA KEO PLANNING PIAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Er-,-,�'INDARD 1 7-j PUBLICWORKS POKCHARFA DECK AR17A TOTAL. I-)LCK/I'0RCII AREA -FGARAGE AREA []DVIAW ED LARCE, PIRDIEPT E EIATI A CA I ,2011. doc revised 06121111 (.o,,a) U11,11 C p-I-S 11lico-16'1-504N DYES BEING AIMEW Ii7No XIMITION? Rg r4o VRF A I1PI K X rION [D)TS IF )IF." RRO"m- covy or �FlItHI-I)c ��k, 0 YI-5 RECEIVED BY: 0 I'Al. VALLIA1 I ON' PLANNING API'l. 'I [] NO PLANNING II0NIr,? El '10 30o o0 By my signature below, I certify to each of the following: I am the property owner or authorized agent to M A`the pmpIty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction I authorize representatives ot'Cupertino to enter the above -identified property for inspection purposes SiV,natUl"C of'ApplicanuAgent Date: WPI'LLMENTAL INFORMATION REQUIRED PLANCHECKTITE ROUTING SIAJI El ONTRA-HE-COLINTER BUILDING PLAARIEVIEW New SFD or Multifamily dwellings: Apply for demolition permit tbr existing building(-,). Demolition permit is required prior to issuance ol"building permit for new building. 0 LxmEss PLANNING PIAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Er-,-,�'INDARD 7-j PUBLICWORKS -�,-Fni if any I lazardous Materials are being used as part of this project. ED LARCE, PIRDIEPT E Copy of Planning Approval Letter or Meeting with Planning prior to El MAJOR , ", "" 1, -AVER DIS r TR rARYS1,IC submittal of Building Permit application. YJ tz"N'N'l RONINIENTAL HEALTH ,2011. doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 19501 scb TYPE OF CONSTR. DATE: 11/12/2014 REVIEWED BY: Mendez APN: BP#: 'VALUATION: 1$65,000 PERMIT TYPE: Building Permit II-A,111-A,V-A PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building IBTIPLNCK $1,589.50 PENTAMATION PERMIT TYPE: 1 B T� WORK Cream- comm. t.i to existing bldq 1273 sq ft SCOPE $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-A,111-A,V-A 1,273 $2,686.90 IBTIPLNCK $1,589.50 IBTIIIvSP $0.00 PME Plan Check: $0.00 Permit Fee: $1,589.50 Suppl. Insp. Feei@ Reg. 0 OT r0701 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 1,273 $2,686.90 $1,589.50 MECH, HOURLY 0 Yes (j) No PLUMB, HOURLY 0 Yes 0 NoELEC, HOURLY 0 Yes 0 No NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the preliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolu/ion 11-053 Eff: ?,'I%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,686.90 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: ) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,589.50 Suppl. Insp. Feei@ Reg. 0 OT r0701 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 F] 0 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Plannin-1 Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i Strom Motion Fee: IBSEISMICO $18.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $4,297.60 $0.00 TOTAL FEE: $4,297.60 Revised: 10/01/2014 I ll� Flo 0 1 DY -111 Wel MA 19:4 JJ R COMAIUNiTY DEV. �E-U)Pi,YIENT EI-EPARTIMENT - BUiLDHNG DIVISiON SALVADOR, P.E,(1G,(-)- BUILDING 0rFK--!Al- CUPERTINO 10300 -T ORR E ;WEN UE - CUPE PT Noz CA 951,i e' -77-2228 - FAX 403 777 -,� -1 -wild -08', f _333 -! I —Ir PURPOSE: The non-residential provisions of the 2013 CalGreen Code outline planning, design and development methods that include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties: establishes the means of conserving water d indoors, outdoors and in wastewater conveyance: outlines means oflachieving material conservation ` I d k re efficiency; and outlines means of reducing the quantity of air contaminants. 4 Project Name: Project Address Project Description Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project, 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section I - 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, General Requirements The project meets all the requirements of Divisions 5.1,')1 through 5.51M. Planning and Design - Site Development 5,106,11 Storm water pollution prevention, F -or of orle ii""re ot doveo)D s4ol-11) k"Vater PGHL,116011 Prevent.an Plarl that has Deei designed, specific to its site. (,orforming to the State Storm water NPDES Corstruuion Permit or local ordinal—ce. "'PArtichever is stri,,Aa7r, --is is reqLmed fol- proiects over one acre. The plan shouk; covet 1,,)revention of snl loss by storm u s e d'i r,, water resin iii and,'ni 0i -J1 erosh Taiter a�, po0ul;on. Column 2 Column 3 Project Verification Reqyirements M-71 Li�l i 11 [ I iI f , 1 , ) f 0 ', i i( I ) -r �! 11 \7� , ) 1 - I? k'N ( '/l C :� /i I - C/t ) . i 1, , �'£-(11 Ff) i V 5.106.4 Bicycle parking. Comply with Section" 5,1( 6.41 and 1. 106,4.2: or (:rdinance,,o.,,Ndiever is stricter. 5,106.4.1.1 Short -Term bicycle parking. if theq,:Jalified project is anticipaited to generwe visitor firafficprITIV rir""hone-, o v i dhe, D e'" me n, 6- r racks %%jithin 200 feet -), the vis';tors' entrance, readhly visbie to passer, m)v7 for 5 percent ',.-t Visilor motorized vehicle parking spaces being AcId"ed, 'oJtn a MiflinIL1111 of onelwo-bike capacify rack. 5.106.4,1,2 Long -Term bicycle parking, For qualified T,)tliflldings ii0th -)ve,, I ") teciar it -occupant"', Provide secore hic.,yocle parkinq for 5 ,,ercent ot ,cnanl vehicle parking spaces being added, with a mintrylLin" onC' space, 5.106.5.2 Designated parking, Provide designaied, parkm"T'01' ally f zi ' I co—bin,ation of low--enlitt;,ng, fuel-eflicient and carpoo"Nan Poni v(Jiides cis shown in Table 5. 106,5,2 5.1 M8 Light pollution reduction, Ou'door liqhring y"Items, shall "Ie designed and instalied to saoniplv with the folowincg 1, 1 hf- rninirriz,)m requ;rernents in the California Eneryv Cooule ':)r iig' Iting zcnos I -- 4 as defined in C",,apter 10 lot fIhe Cai"ifornia, Code, 8n, 2. Backlicp'ht, Uptight and G'Iare (BUG% ratings as defi'ned in lf-S TM -15-1 1: and 3. Allo-,vablc BUG ratillig not exce,-:�dinql these shown ij,, T a ble 5, 106 � 8, Or —or-riply with a loc-N orcirlance Iawfl.'Aly enaAed pt-irSuant to Section 10 ,11.7, +.A)hchever a mare strincert, 5.106.10 Grading and paving. The site shali be Planned and developed to kee-p surface water away frorn budldlingp. CDristruction pians shall indicate hovt s:tc- grading or a drainage systern1',fli manage all sbIaGe b,%,ater (`I0W5 Performance Requirements 5.201.1 Scope. The California Ene.rgy Carrin-iissior ovill confinue to adopt mandatary building standard,,. Indoor Water Use FIM IW NO 5,303.1 Meters. Separate meters s-Iall be in,'sialled for We uses describer, in S e c t i o r is � 03. 1 ,1 ano -5,'0, }.1.2, 5.303.1.1 New building or additions in excess of 50,000 square feet. M-77 Separate si-ibinetes shall be instaliad as fall .w^ .for a; _)C` jr! JOaSi]',d, re �rated ol othef ter anvs';illhin the, building projected to c'cnsume more than 10C) gal/rjay. J. 2. Vvfhere separato slubmeters are unfeasirAe, i0r vv'atet supplied to the followino s',Vsten�s: i a. Maketip water for cooling to'vvers where flo,,titorr ough sareater thin 500 gpM. b. NIakeup water lor evaporative cc)olers greaterthar 6 cipm c. Steam and hint-viater boilers w0n, energyniput 5:00.0f,30 R-Btt.vhl' 1 - -------- - V [00 5.303 A I Excess consumption. i\ in L^ ❑ for any tenant vilin a new bAking or wit un an addAn Hart is pryeaed -J to C,0f-lSLJrT1-- > !,COO gal day. . . .... . . . . ........ . . . . ....... – --- ---- — - - ------ . .. . . .. . ..... . ...... 53032 Water reducDom Flumbbyl fixtums shall meat the nmxvniwn Pow rate ValUeS ShONAJI in Table 5,303.2.3 - Exception: BUi!ding that demomstrate 20 -percent overall water use ielucfion, 53032A Areas of addMon or aHeration. =7cr those, occ-upancios �vvithrl Me autbority of the California BuiAng Smrldards C/ominission, as specified in Section M d he provisions of Ser 5.30&2 and Ser* <n 53033 sh1l Lai ypy W newfixtures in adoitiors of, areas of alterahmis to an bubdings. 5.3113.4 Wastewater reduction. Each building shall by 20 percen't LZJ wastewater by one of we hallowing MUM 1, The installation of water -conserving fixtures or 2AJJfiHzin,g non -leo tab iewater systerns. . . ........... . . .... — ------- -- ...... M\/ 10101 1 1303A Standards for pIL1Mbi1)g fiXtUres and fittings, Pia nbin- lixtures and . .. ...... i Atthys. s%H be installed in accardance with fine Cali(ornia Pfuanibinn C -,'ode ❑ (CPQ and shall meet the applicable standards rdeienced in Table 140 !.1 and CalGreen Clhaptet 6� Outdoor Water Use 5.304.1 Water budget. A water buoget shall be developed fov iandscape i in L^ ❑ AgMion use. -J . . ...... . . 5.304,2 C)Wdoor potable water use. For nevvvvatev service o! [or additii:)n or alter. quiring upgraded water service hr Andsmped areas of at hast alteration - re 1 POO sqTbA not mom than "ON sq.ft- separal.eSUbrnel,,rs of r-nefering � devices shall be inslallici f-f)r,)Utd00r potable vvaterusr,. 5.3013 Irrigation design. In new nonresidential constivabon or o0ding addition or aileration, vvQh at least 1.000 b& not more thain 2,-500 sq,", of cumulative landscaped am, ustall AgAon cwhollars ami serams wNch "ollovving include tile criteria, and ri-ieet rnanufacture.,'s rpcmrmendations LZJ 5.304.3.1 Irrigation corqmHun Autooiaflc irrigation systenl cwHrollers' AvInTed at Te time of final inspection shall corgi ply with t1fle fnfblving: p 1-Cowroile-'s shali be smaMer- or sail that auumnatically adjust idgation in response ochan,,",es In pja'-Os" r"eedilsas El vv,eailhor candilion,s change, 2. Weather -based conkdery w0aw hingA An smans or "orm-nuricalion , YsIterns bat accou-rt fior (oGal rainfallsl,,ali have -3 seta irate tvined or winviess rak sensor which connech or communkates with We cm1d4r{sy Sol mohUire-based zor:huller s ave riot required to have. rain sensor input, Weather Resistance and Moisture Management 5.407.1 Weather protection, Provide wall and fOLMdation, envelope as required by Cah��o,?nkr Bt,'Ji'ding Code,, Sectiori 1.103,2 r—T Li and California EnorqlCv r Section 1-50. Mtructions or Mai crdinianGc, -odhichever is mue s1QteW. I ...... . . . .......... . ...... .... Paw 3 ON ( , cctl N")!] A'es ( u(, v,,v,,w6/ iel '2-4`14 5.4072Moisture control, Empofmoimupacon0n |measuresby1",y0�h�vj \ m*tkmjs: � 5.407.2.1 Sprinklers. Prevent /nigobenspray on strndun,a. 5.4W7.2.2Entries and openings. Des|gnex,crio/antde.oand/or openings tup/eventwm o|o,in�sion into buildings. | LLJ � 5.407.221 Exterior door protection. Phmaryovehorenmosumak � beoovcxadWprevent v,)a0erinUuxionbyusing non. bso/bentUoorand | wa||5niahaswiUi|natleast 2ftaround and perpendicular ioouuU Openings Nus '91,ieautone, ofthe foUovving: | 1 An/nata|k,,dmloioingatleast 4ttiodapK | | / 2,Thedcwrisprotected byaroof overhang at|east 4hindep1h� | | JThe door /srecessed at 4ft. | | 4.Other mehoUawhiciiprovide equ\valen! pfotecion� \ 5.40722.2 Flashing. flashings in|mg:a*advNth a p|ane Construction Waste Reduction, Disposal and Recycling 5.408.1 Construction waste management. Rec�.,de andlor salvage for reuse P. minirnurr, of 50 percent of the nonhazardous cons1ructiron aid dennalklicon i M77 5.4n8.1.1Construction waste management plan,8ukm�t: plan PeINS | �� �l o:c�iontoenfnroomen�auU,o�� ' �� � �� 5/0812Waste management company, Uidizeaviastemanaga.11-lerl� � oornlpany 1hpt can provide vehfi,ableduouxmn4aUunthat the pooeniageof construction and dmmo!ihuownst:mmer�a|divenedhomtAe|undfill 5.4o81]Waste mtmomreduction alternative, The mmigh�of i ne�mnns1mo�ondiuposa|U`otdamano�exuoodhwupoundapersque:e foot n|huil&ngaoeamaybedoemadiomeot thu,50paroen\r:Nin*m requirement enappmvodbyrh,eenhoxcinAo�ency� 5.4OV.1.4Documentation. PmvinndooumenteUonthewaa|a monagameniplan /hoimeets the equ|,emen1eUxmdinSection 5,4DO,1 1 through 5.408,1.3, � 5.408.3Excavated soi|and land clearing debris. 100peron/n'kees. | uturope,,wckoand ouxmc-Jatedvegetation and yo|!sresulting pdmar|yhon land | Fl doaringsha8boeusedormuyoed. � -- � -- Building Maintenance and Operation ' 5.410.2.1 Owner's Project Requirements (OPIR), F)ocuryienied before the n H i.nc.lude irems li&ed m e s i g n p h as e o, t h e prosect b e g i r's e C, i R s h @ Sector l 5,4 LAJ 5.410.2.2 Basis of Design (BOD). A vvritten, explanation of how the, deign Of the huilding systems ryieet-z f(he CPR sha'l iDe at it e d e s i q rt phase of thie burlding proiecl and penodicaliv io caver il,-e, syslle nns listed r Sechor-, 5 4 10,2.2. 5.41 0.2.3 Commissioning plan. A. can -imissioning c)1zin de cribii q how tide pro ct vffl he cornmissioned shall he started diuring the, dSlar, phase the hufthn(;,;3r.oiecl and shall include: darns fisted it) r-ection 5,4101 2-3. I/N 5.410.2.4 Functional performance testing, Functiot-6;' pencirmance te-I ing `shill derno,";,si rail, r, th(.7,, correct instal'ato, an(I on,,ra ticin •A' each cornponent, systern and System-to-SN/stern interface it, Fwllor C, ince vv!th he approved plans and 5,410.2.5 Documentation and training. A Systems inanldal ar;d sym,ems training are real,,uired. LCJ 5.410.2.51 Systems manual. 11hesysterns nwnua' shali be, deiivered to the bluildil-Ig owner oti representative and [acikties i?r-id shiall F-71 irclude the, items listed in Section 5,410.2-5,1 5.4,10.2.5.2 Systems operations training. TIhe trairing. of the appro,rdnle maintenance saff for eacht ecuipt-nent I -pe andl(r system Y r;hall tcrns iisted it Secr,-) 5.410.2.6 Commissioning report. A "ornIpIf"te rer)or( o; cunlrn!ss;orvna process activitie, undertiken, 1hrouch the de '!ii co'nstouction and reporting, rec.,ornmendlations for post-construclion of the, build,ng M77 oro�ip i �ct shall be campleted and provides to the owner orrej-)les(,m; .-Ave. 5.410.4 Testing and adjUStit1g. J eStifig and a(ELIStit-Ig Of ShJ11 be required for buildinus less than 10,000so-ja,e feet O)r ne,,,*,, systenos to :se,iv' ve Fit, , ad or) or altera"! )n stlbiec? to section 3011. Ch"i C 5.410.4.2 Systems. Develop a .utter, plan of procediurFs for IeSaing and Jed lot testing and adiusting sltvill a I d"usting zsystenns. Systerns to be inclu( include, as appiicablp to the protect, the systerns Nsted io Section J +107 3.2 5.410.4.3 Procedures. Perform testing an,-! ndjusting procedures 'M accordance with industry' best pra,-.Air,;es and applicabie nak)nal sLandar-s On e-ach sysipm. 5.410.4.3.1 HVAC balancing. Before a nevv s-vstem ser VIJng a bufldir,,q or .space is Sher ated fn or of 1. i he syster n ,hould b(,, balanc.H.d ir accor-lw -e the res dt'fined bw n -atio no I standards isted :`.ri :`.rSection 5.4110.10.3,1. 5,410.4.4 Reporting, Atter c3iviplleboil of testiina,a gr adpstinnd bai,)YICU-�g, J provide a FInal report of testing sic - ; y)ed by the i��ciiv'dh.iai esponsible for r7I petl,Otmirig ;`hese setvce-;- 5.410.4.5 Operation and niiintenance manual. Prcivide the building owner with detailed npera6ny and r-)a�ntenance instructions, -and Copies of M-1 L/21i for each sYstenn prior to final 5,410.4.5.1 Inspections and reportsincluc-IR, n crap y 7,f ah inspecdun veiilicatiuns and reports requfferi b,,,f the ei)lorcing agoncy, 100 10 FRI FMII Fireplaces 5,503.1 install only a direct -vent sealed-DOP01UStion gas ur sealed ,Ajood- burning fireplace or a sealed woodstove and refer to :es'Aeniia l !-eClUireiments ;M the Cail'bl"Ma LOC!(f y 'ode. _t itle 24, Pert h,, Subchar)ler 7, Section 1 C" 5,503A .1 Woodstoves. ",,'Voodstoves sr,,aif con ply'vvith LJS EPA Phase 11 ernission limits. L Pollutant Control 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of roi igh ii st�fflation or during storage on the construction site and until 1-inal sta.r1up of the heating and and Other related air d stribUtion cormpc cooling equipment, all duct Opening: shall be covered with tape, plaslic, sheell. melill or oflher rne'll-icods acceptable to the enforcing agency to, reduce the anhC'Urlt Of alsl off debn's v,i 1) i c h may collect In the system. . . . . ....... . ... . 5.504.4 Finish material pollutant control. Finish rnatei'ialssh;all cot-nvyvvith y I S "ectic 5,504,41 thrr ugh 5.504,4A, 5.504.4.1 Adhesives, sealants, caulks. Adhesives andsealanTs used on the project shall nieet the requirements of the foilowiing sitandard,,�, I. Adhesives, allllhesive bonding primers, adhesive primers, sealarils, U. sea!ant prinlers and Cco aulks shall mplyvvithi localornF;gional ,",'iip lilution control or air quality n-tariagement dist, 'ict ruies vvhe,r a( p;; L- 171171 SCAQMD Rule 1 '68 VOC Iinni�s, as shovvn In T ables 5504,41.1 a- n1d 5,504.4_2, 2 2 . Aerosol adhesives and smallel- UnitSiZeS of adhesives and sea ant or caulking compounds in Units, of prioduct, less packaging, whi,;h not weigh more than one pound and do ncit consist of rrot'e Nllan '1P, fluid IV jl.j,jPly Wir ri ounces, shall 1h sta, wide VOC standards and nfhe,, F1 requirelents, ncludirng on use of Pertain 4oxic c(jn­,i)-'.)tJndS" of Ga/ifornia Codo ,,,f Regulations, T ifle 17, cotnrien)rinq ,,,filh Secjiorn 94507, 5.504.4.3 Paints and coatings. ArchitectUral paints and coatings sh,0 �'amply with Table Com) ?74.4.3 unle'", more 6tringent oall 'itnitsar"P[ V. L_J ❑ 5.504,4.3.1 Aerosol paints and coatings. ;,kemsoi paints ,'-indl coating's, 1 shall meet the Product-'V'Veighited MIR Limilts r'Dr ROC S-ki,-,tlon 945222';:t)!3) e"'nd c"ther r,equirerne­ts, including prohliNtions oin Llse'` Of El certain toxic t.1-ompounds ant,, o7one deptet ing subsia;es ?'CCR, Tile 1 S,e4.-fi,-,n 9,4520 et seri). 5,504,4,3.2 Verification, ale:" ircat'on of corniol'ance, with this sechon ;Mali he provided at the request ryf the enforong agency'. 0 5.504.4.4 Carpet systerns- All carpet in the buildling'i shalt ryieet the testing and procitict reqUirem.pnts of at least une of the standards lisled in Section 5.50 4.4.4. L_^j 5,504.4.4,1 Carpet cushion. Al? carpet cushion in the huiwfinq interior shall rneet the requiiernents oi [he Carpet amc, Rug It 15"Itute (_:.-Mlen Label prcgrarn. 5.504.4.4.2 Carpet adhesive. Ali cat -pet adhesivo shall r'Ylt'-et the requwL,rnents of Table 5.50,1,41, 'uOC (I G 1' i) "dr ;f :'cn '"-R" V 'i, ajf?c ;-' v! _tcd 0 5.504,4.5 Composite wood products. par,' 'ic le b on,d, r and medium density fiberboard composite ,,%iool" proct dus, t, sed oil interior or exterior of the building 4lpli i-ueet tm r tie requireonts tile El (orr-nald.'etwde as specified in Table 5,504.4,5, 5.504.4.5.3 Documentation. Verification (A ,,vilthi 1,Ns section rzn El shall be provided as requested by the einfoming aces ,y. ition nrld Chapter I A A . . . . . ...... . . ...... shall induct ',- at least one of inn following standards..sled In Section ........... . .. 5,506.1 Outside air delivery. For medhanica0y ,,)r natt.iraiklv, ventilated 5.504.4,6 Resilient flooring systerns. For 80 percei1l, of fkoor �",(Yll'l E!ieiuv Codi -,,,C Title 24, Part it andi Chaoler 4 of 8 or the recetvina resilient ifloorin'g, instadled resilient it oririg "'i all meet at least onie applicable local code, whiuhever is !no?e stringent. El at the "Cliowing standards tisfed �n Ser inn LJ de -nand control ,,e-ittlation, CO2 sen sors and -veritilation conlrois shall be 5.504,5.3 Filters. In mechanically ventilated buildings. provide rcgu!jyl�f specified and installed in acce rda, rice with the requiremews of the I ocCupied areas of -lie buiUng with air filtiatior, media to, outside and, M7, Environmental Comfort return air prior to occuparcy thiat r),rovides at feast a MEPV of 5,507.4 Acoustical control. Eimploy til ANjing &�Ss kr-,s and cornponents -i'01 1r7i 5.504.7 Environmental tobacco smoke (ETS) cantrol. Pr""nibit slrokmg .44,ithiri 25 feet of building; entries, nutdoar aiH ;Pitakes and operable are-ao afe provified for smoking and it build q7,, w a6 enforced El by ordinances, regi-lotionst-)r poFlcies of any city, county, fill}, and county, LJ Californoa Comn,iunity Colleqe, callr"Pus of the California sti-ate, Un:�.,,ensitv or campus of the University ol Calilorria, whichaver are, more st?' Indoor Moisture and Radon Control 5.505.1 Indoor moisture control. Buildings shall rneet oar exceed the provisions of C�),,'ilforriia Buiidiny Code, CCR, Title 24, Part 2, -1203 L nrld Chapter I A A . . . . . ...... . . ...... Air Quality and Exhaust ........... . .. 5,506.1 Outside air delivery. For medhanica0y ,,)r natt.iraiklv, ventilated in builinnineel, the froiinnum fectuirernents of Sr ior '12" of the --H. li'ie E!ieiuv Codi -,,,C Title 24, Part it andi Chaoler 4 of 8 or the applicable local code, whiuhever is !no?e stringent. .... .. ..... 5,506.2 Carbon dioxide (CO2) monitoring. lloi tYjildirigs equi,ppej'i.Alh de -nand control ,,e-ittlation, CO2 sen sors and -veritilation conlrois shall be specified and installed in acce rda, rice with the requiremews of the I of the California F-i-;Pf�y Ccide, CCR, Title 24. Part 6. Section 121 (c), ------- Environmental Comfort 5,507.4 Acoustical control. Eimploy til ANjing &�Ss kr-,s and cornponents -i'01 1r7i intim SSC values determined in accordoric-, wilh A31 E 9(1 a� nd AS`[ M E 4 13. L 5.507.4.1 Exterior noise transmission. Vv"all and floclr-cf�iling assernbk-is in,akiig up'he buildirg enivelolpi-, shalt have an STC of, at least 50 a3id extend,' w;*nd,,),ojs shall have a mlnitis ual STC of 30 for any of the, ht(?ding LCU ❑ ioca,fions listed , Iterns I tyre gun 3 ;n Section, 1. 5,507.4.2 Interior sound, il,Idll and separa'kirlU teria nt spaces and Tenant spaces and pdbtlC,j Places Shall have an S71'c, or at ieast 40. Outdoor Air Quality 5.508.1 Ozone depletion and greenhouse gas reductions. installations of HVAC, retrigeration and fire suppression, equ.1t s ipme- h,,:,ffl comply with c,- Sions and, 5.508.1.1 Chlorofluorocarbons (CFCs). instal; HVAC ar-,,d uquipmew that abes not conta4i C.F"-,s. 5.508.1.2 Halons. install 5,e supp—cssion equipment that does, n, HIons, U:J Pa e S ot I' C,,Cheo',l I ' } Project Name: M_ . C: _ .._— _ Off_. Project Address: cf_ Proem Description: • s • Complete all lines of Section 1 —"Design Verification" and submit the competed checklist (Columns 1 acd 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards hravc revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented irto the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted t3v;he Ci!g of Cupeeonp;4,,, r s"Sruria!t.rre � s is Name (Please Prin 'r Design Professionals 5igrrUt CAD- ) -Design Profes iona{'s Pda `(Please,r'rtpt) ......_ Signature of License Prnfession i ,, o. r C,reen co.trrpliance Name of License for CalGreen, co npir ir.e ,"Ilease Print; Email Address fur Lr ;erse Profession -i: respori .ib.e 10. kCalCreen Date Datr �)aath PI nae Complete, sign and subrnit the competed checklist, including column 3, together with all original s gnatures on Sectran 2 to the Building Department prior to Building Department final tr•.spection. I have inspected the work and have received sufficient documentation to verify and certify that the project idenflfierl above was constructed in accordance vvith this Green Building Checklist and in accordance with the reguirentenfs of the 2013 California Green Building Standards Code as adopted by the City of Cupertino, Signature of L, er,se Professional responsible for C alCree , c*aRIpriaFoe Date Name of License Pro`ession.d es>onsik,le ler CalGreen coy -ilpfi n , (Please Printf Phone Err�41 Address for License Professional responsible for CalGreen coruip!ian�.e ­ w cd CUPERTINO PURPOSE: CALGREEN NON-RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION c�+'1� pj� ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL �i� �I Ai 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 FEB 0 2015 (408) 777-3228 • FAX (408) 777-3333 • buildinafakupertino.orq The non-residential provisions of the 2013 CalGreen Code outline planning, design and dee"-v-fopment methods that include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines means of reducing the quantity of air contaminants. Project Name: Project Address: Project Description: Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 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. I J U"MITTAL FA -01 1111111111111;7 W MANDATORY FEATURE OR MEASURE Project Verification I- Column Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements . •- CHAPTER 5 - NONRESIDENTIAL MANDATORY MEASURES General Requirements Gene -rhe project meets all the requirements of Divisions 5.101 through 5.508. Q ❑ Division 5.1 PLANNING AND DESIGN Planning and Design - Site Development 5.106.1 Storm water pollution prevention. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been designed, specific to its site, conforming to the State Storm water NPDES 0 ❑ Construction Permit or local ordinance, whichever is stricter, as is required for projects over one acre. rhe plan should cover prevention of soil loss by storm water run-off and/or wind erosion, of sedimentation and/or of dust/particulate matter air pollution. Page 1 of 9 CalGreen Non -Res Checklist.doc revised 01/23/14 5.106.4 Bicycle parking. Comply with Sections 5.106.4.1 and 5.106.4.2; or meet local ordinance, whichever is stricter. ❑X ❑ 5.106.4.1.1 Short -Term bicycle parking. If the qualified project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers-by, ❑X ❑ for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two -bike capacity rack. 5.106.4.1.2 Long -Term bicycle parking. For qualified buildings with over ❑ ❑ 10 tenant -occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low -emitting, fuel-efficient and carpool/van pool vehicles as © ❑ shown in Table 5.106.5.2. 5.106.8 Light pollution reduction. Outdoor lighting systems shall be ❑ ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones ❑ ❑ 1 — 4 as defined in Chapter 10 of the California Administrative Code; and 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM -15-11; and ❑ ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or ❑ ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ❑X ❑ site grading or a drainage system will manage all surface water flows. Division 5.2 ENERGY EFFICIENCY Performance Requirements' 5.201.1 Scope. The California Energy Commission will continue to adopt ❑ mandatory building standards. Division 6.3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1.1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. ❑ ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the ❑ ❑ building projected to consume more than 100 gal/day. 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater ❑ El 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot-water boilers with energy input > 500,000 Btu/h. Page 2 of 9 UalGreen Non -nes cnecknst.aoc revisea ullzxi If 5.303.1.2 Excess consumption. A separate submeter shall be provided for any tenant within a new building or within an addition that is projected ❑ ❑ to consume > 1,000 gal/day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate values shown in Table 5.303.2.3. Q ❑ Exception: Building that demonstrate 20 -percent overall water use reduction. 5.303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall ❑X ❑ apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water -conserving fixtures or Q ❑ 2. Utilizing non -potable water systems. ❑ ❑ 5.303.6 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code M\7 ❑ (CPC), and shall meet the applicable standards referenced in CPC Table 1401.1 and CalGreen Chapter 6. Outdoor Water Use 5.304.1 Water budget. A water budget shall be developed for landscape M\7 ❑ irrigation use. 5.304.2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least ❑ ❑ 1,000 sq.ft. but not more than 5,000 sq.ft., separate submeters or metering devices shall be installed for outdoor potable water use. 5.304.3 Irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft. of cumulative landscaped area, install irrigation controllers and sensors which ❑ ❑ include the following criteria, and meet manufacturer's recommendations. 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that ❑X ❑ automatically adjust irrigation in response to changes in plants' needs as weather conditions change. 2. Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates M\7 El the controller(s). Soil moisture -based controllers are not required to have rain sensor input. Weather Resistance and Moisture Management 5.407.1 Weather protection. Provide a weather -resistant exterior wall and foundation envelope as required by California Building Code Section 1403.2 ❑ ❑ and California Energy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent.' Page 3 of 9 CalGreen Non -Res Checklist. doc revised 01123114 5.407.2 Moisture control. Employ moisture control measures by the following methods; 5.407.2.1 Sprinklers. Prevent irrigation spray on structures. ❑X ❑ 5.407.2.2 Entries and openings. Design exterior entries and/or openings ❑ ❑ to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and ❑ ❑ wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following: 1. An installed awning at least 4 ft in depth. 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection. 5.407.2.2.2 Flashing. Install flashings integrated with a drainage ❑ ❑ plane. Construction Waste Reduction, Disposal and Recycling 5.408.1 Construction waste management. Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408.1.1, 5.408.1.2, or 5.408.1.3; or meet a ❑X ❑ local construction and demolition waste management ordinance, whichever is more stringent. 5.408.1.1 Construction waste management plan. Submit plan per this ❑ ❑ section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of 0 ❑ construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408. 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square ❑ ❑ foot of building area may be deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5.408.1.4 Documentation. Provide documentation of the waste ❑X ❑ management plan that meets the requirements listed in Section 5.408.1.1 through 5.408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, from land ❑X ❑ stumps, rocks and associated vegetation and soils resulting primarily clearing shall be reused or recycled. Building Maintenance and Operation 5.410.1 Recycling by occupants. Provide readily accessible areas that serve ❑X ❑ the entire building and are identified for the depositing, storage and collection of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the ❑ ❑ design and construction processes of the building project. Commissioning requirements shall include items listed in Section 5.410.2. Page 4 of 9 CalGreen Non -Res Checklist.doc revised 01/23/14 5.410.2.1 Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in ❑ ❑ Section 5.410.4. 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems X❑ ❑ listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of © ❑ the building project and shall include items listed in Section 5.410.2.3. 5.410.2.4 Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each component, system and system -to -system interface in accordance with the ❑X ❑ approved plans and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems operations training are required. ❑X ❑ 5.410.2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall ❑X ❑ include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type and/or system ❑ ❑ shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and ❑ ❑ reporting recommendations for post -construction phases of the building project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303.1. 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall include, as applicable to the project, the systems listed in Section ❑X ❑ 5.41 0.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards ❑ ❑ on each system. 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a building or space is operated for normal use, the system should be balanced in accordance with the procedures defined by Q ❑ national standards listed in Section 5.410.3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for 0 ❑ performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of ❑ ❑ guaranties/warranties for each system prior to final inspection. 5.410.4.5.1 Inspections and reports. Include a copy of all inspection ❑ ❑ verifications and reports required by the enforcing agency. Page 5 of 9 CalGreen Non -Res Checklist. doc revised 01123114 Fireplaces 5.503.1 Install only a direct -vent sealed -combustion gas or sealed wood - burning fireplace or a sealed woodstove and refer to residential requirements 0 ❑ in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase II emission limits. Q ❑ Pollutant ° Control 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component 0 ❑ openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or 0 ❑ SCAQMD Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and other 0 ❑ requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall local limits Q ❑ comply with Table 5.504.4.3 unless more stringent apply. 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on use of ❑ ❑ certain toxic compounds and ozone depleting substances (CCR, Title 17, Section 94520 et seq). 5.504.4.3.2 Verification. Verification of compliance with this section Q ❑ shall be provided at the request of the enforcing agency. 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards ❑ ❑ listed in Section 5.504.4.4. 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute ❑ ❑ Green Label program. 5.504.4.4.2 Carpet adhesive. All carpet adhesive shall meet the 0 ❑ requirements of Table 5.504.4.1. Page 6 of 9 CalGreen Non -Res Checklist doe revised 01/23/14 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for �X formaldehyde as specified in Table 5.504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section ❑ ❑ shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following standards listed in Section 5.504.5.3. 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one ❑ ❑ of the following standards listed in Section 5.504.4.6. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and ❑ ❑ return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced ❑X ❑ by ordinances, regulations or policies of any city, county, city and county, California Community College, campus of the California State University or campus of the University of California, whichever are more stringent. Indoor Moisture and RadonControl 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203 Q ❑ and Chapter 14.1. Air Quality and Exhaust 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California ❑ ❑ Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with demand control ventilation, CO2 sensors and ventilation controls shall be ❑ ❑ specified and installed in accordance with the requirements of the latest edition of the California Energy Code, CCR, Title 24, Part 6, Section 121(c).' Environmental Comfort 5.507.4 Acoustical control. Employ building assemblies and components ❑X ❑ with STC values determined in accordance with ASTM E 90 and ASTM E 413. 5.507.4.1 Exterior noise transmission. Wall and floor -ceiling assemblies making up the building envelope shall have an STC of at least 50 and 0 ❑ exterior windows shall have a minimum STC of 30 for any of the building locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4.2 Interior sound. Wall and floor -ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of ❑ ❑ at least 40. Page 7 of 9 CalGreen Non -Res Checklis[.doc revised 01/23/14 Outdoor Air Quality 5.508.1 Ozone depletion and greenhouse gas reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration ❑ equipment that does not contain CFCs. 5.508.1.2 Halons. Install fire suppression equipment that does not contain ElHalons. ED Page 8 of 9 CalGreen Non -Res Checklist.doc revised 01123/14 CALGREEN SIGNATURE DECLARATIONS Project Name: �,p( Project Address: 125-b-1 5M✓W!5 Gf 4ft,' Xzub- a i s2„ J CA1;?EgT7Wo CA 95 or�. Project Description: 94F.-- czfAm � �p SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 — "Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Date Owner's Name (Please Print) ./ //// , Design Professional's S re %/1 Date Design Professional's Name (Please Print) Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 9 oF9 CalGreen Non -Res Checklist. doc revised 01/23/14