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14060137I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10376 TONITA WAY I CON TRACT R: NIKOLIC GENERAL I PERMIT NO: 14060137 OWNER'S NAME: VAN SCHAACK .JOHN R AND DONNA 13953 HAMILTON PARK DR I DATE ISSUED: 07/28/2014 OWNER'S PHONE: 4082523836 1 SAN JOSE, CA 95130 l PHONE NO: (408) 260-8905 LICENS�D CONTRACTOR'S DECLARATION I TD License Class Contract (er ate —1 l I hereby affirm that I am licensed and" 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. /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 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 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signatureiz Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner ofthe 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 construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] CONSTRUCT ONE STORY ADDITION (360 SQ FT); ADD (N) WINDOW IN FAMILY ROOM. Sq. Ft Floor Area: I Valuation: $67000 APN Number: 35915046.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PE SUANCE OR 180 DAYS F EDINSPECTION. Dat7 Ae: , 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. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533 and 25534. Owner or authorized agent: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingcu ertino.org rC-I �U PE C'RIC)` I N O �T FI I -7na �NRW NRTRI IC'TIC)NJ � A r)r)ITTOI I N AI T R ATTON / TT RFVTRTON / UPFFRRFII \ �V ORIC:INAI. PFRMIT # rte W4 r� PROJECT ADDRESS f0'3'J 1VA) 17-A APN # owNEel10/U flryf w Slr�� -25� - 3 AIL - BMs STRE.E✓Tp'DPJt -M/V/7*W TY AA E, ZIP tV +0 7 �r-Y1�Jt FAX / -T CONTACT NAME c l� PHONE E -MAIL STREET ADDRESS G^ d��y,� CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWWNFRRAGEENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ISTRACTOR NAME �1 i ® ICE SE NTgt y - / LICENSE TY!'li7 �G.J, BUS Lj1C # ��C���"/•�v`JG C pjS EG�Tt,° y FAx^'" �,�(� i ill I 1 C / .�R ? RESk w 14 ty vA)/_p ..Vej,STATE, C/�o cA 95/30 VS_ V 40 A' LICENSE NU MBER BUS LIC # Iq+NCY'•E COMPANY NAME E-MAIL ps' FAX STREET ADDRESS �PQI.� `'Ci/ ��� CITY, STAAT"E, ZIP q`� �s�Ci Qt , Y� PHONE DESCRIPTION OF WORK P, /pp rD k_7X1'S77A)6 -House 3)60 Tvo 7f Lo 4 Z) 3 / R ` / EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA — NEW FLOO AREA DEMO AREA TOTAL NET AREA 3604 � BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA DETACH ❑ ATTACH # DWELLING UNITS IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? DTJO ADDITION? I&NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES. I TO L VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO `yam 0. Q-0 00 By my signature below, I certify to each of the following: I am the property owne oriz en�'��Ope er's behalf, 1 have read this application and the information I have provided is correct. I have read the Description of Work and ve comply with all applicable local ordinances and state laws relating to ldiingg constructioge I auth n representatives of Cupertino to 2roperty for inspection purposes. Af �✓ Signature of Applicant/Agent: fzoa Date: — /C.. 01 '/ SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROOTING SLIP _ New SFD or Multifamily dwellings: Apply for demolition permit for [] OVEWTH&C61UNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. �7 AS/EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure /!❑ STANDARD ❑ PUBLIC WIDRES form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ EIRE DEPT, Copy of Planning Approval Letter or Meeting with Planning prior to ❑ ❑ sT#R SEWER DISTRICT submittal of Building Permit application. El ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06/21/11 M CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10376 tonita way DATE: 06/23/2014 REVIEWED BY: MELISSA APN: 359 15 046 BP#: `VALUATION: 1$67,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition IADDPLCK PRIMARY USE: SFD or Duplex 70TC? 2nd Unit? Yes • No Yes ® ®No PENTAMATION PERMIT TYPE: 1 R3SFDADD WORK ADD 360 S.F. TO BACK END OF 1ST STORY TO CREATE N MASTER BEDROOM SUITE. ADD SCOPE (N) WINDOW IN FAMILY ROOM AREA (5040) Suppl. Insp. Fee:) Reg. Q OT OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,N,V-B 360 $1,579.00 IADDPLCK $1,284.00 IADDINSP $0.00 Permit Fee: $1,284.00 Suppl. Insp. Fee:) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 360 $1,579.00 $1,284.00 MECH, HOURLY 0 Yes E) No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY 0 Yes 0 No F-1 _L_ 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 preliminar information available and are only an estimate. Contact the De t or addn'l in o. FEE ITEMS (F,ee Resolution lI-053 Eff 7.'I!132 FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,579.00 =# $834.00 Window / Sliding Glass Door I WINMEWSTR New (Shearwall/Masonry) Suppl. PC Fee: (j) Reg. 0OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,284.00 Suppl. Insp. Fee:) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? © Yes No $0.00 Advanced Planning Fee: IPLLONGR $50.40 Select a Non -Residential E) Building or Structure i Strong. Motion Fee: IBSEISMICR $6.70 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $3.001 SUBTOTALS: $2,923.10 $834.00 TOTAL FEE: I $3,757.10 Revised: 04/01/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: '%/(f 1 7;( Wfq PERMIT # 0 6 0 /3 7�- OWNER'S NAME: IJ V A AA- ' PHONE # GENTERAL CONTRACTOR: /&01-1C &CA.)6Z*L WA)-VZu —AQ&NESS LICENSE # 3 S S ADDRESS:_` Sq53 �-M7L(/L/Vr K) -P/fZ& k. , S, .7. q-57 CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. , I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date I ENERGY COMPLIANCE DOCUMENTATION CUPERTINO Building Department R E V I E VA -0 rUR Oil) E0 iV; P'L i A N PROJECT: LP#A/ VAIV /493 723*1 r,4 Job # 11'-37 PREPARED BY: Phil S. Laureles 608 Marin Ave., Hayward, CA 94541 (510) 785-0300 SU���ITTAL Prescriptive Certificate of Compliance: CF - I It A1)1) Residential Additions (Vale I of S) Site Address: /�� %bN%T� lt/,�Y i?nforcement AVenCN, Date: E F G I H I General Information Proposed Project Narne / _ C;r�D/7-��� Climate Ione fE fit" 4 of Stories / - rtic►-v Building TypegSingle Family ❑ Multi Family Circle the Front Orientation: N, L, S, W or Degrees Conditioned Floor Area of Addition (CFA): 36pp New Addition Size: M Less than or equal to 100 ft'`FKess Do not use this orm or additions than or equal to 1000 ft' greater than 1000f12) NOTE: For Alterations to an existing home, submit a completed CF -IR -ALT Form Exception: Existing HVA Cs stems that are replaced or altered to serve the addition may be included on the CF -IR -ADD Form. PRESCRIPTIVE ENVELOPE REQUIREMENTS FOR ADDITIONS JA4 Assembly Cell Values For standard wood and assemblies meeting the Cavity R -value only. • For 100f? additions; the Proposed values must be equal or greater than the Standard column or when indicated when using Package D, "Pkg D ". Enter values in the shaded Proposed Columns. • For less than 1,000 fi2addilions must comply with "Pkg D" requirements unless indicated in the Standard Column. To meet "Pkg D " minim:ttn energy compliance re uirements, see RCHAPPendix B, Table 151-C or 152 in the RCM. Enter values in the shaded Proposed Columns. Size of Addition 100 1111:2 or less Less than 1,000 ft2 Component Standard Proposed Comment Standard Proposed Comment Ceiling Insulation R-19 Minimum Pkg D - Table 151-0 Wall Insulation R-13 Minimum R-13 —/3 Minimum Floor Insulation R-13 Minimum Pkg D I-4 Table 151-0 Fenestration U- U- factor SHGC factor SHGC 0.40 Pkg D Enter Values From "Fenestration 50 R2 > — Areas" Page 2 of 5 U- factor SHGC U- . factor SHGC Enter Values From "Fenestration Proposed Areas " Pae 2 of 5 0.40 Pkg D Maximum Glazing Area t Addition Alone' 72ft Enter Values From "Addition Allowed Fenestration Areas" Page 3 ofS For West-Faciog Orientatioa2} Radiant Barrier N/A Pkg D Table 151-C Roofing N/A See Roofing Products Below I Pkg D See Roofing Products Below OPAQUE SURFACE DETAILS For the furred portioned of Mass Walls see Furring Stri Construction Table below. A B C D E F G I H I J Proposed seeNote Standard Values From JA4 Table Ta�/ I Assembly Name or T 2 Framing Material and Sizei Thickness, Spacing, or Other' Framed U- JA4 Table Cavity facto Numbers R -value Continuous Insulation R -Value' JA4 Assembly Cell Values Proposed Assembly U -factor gm�GE 2 // O 2--.51A 4.,0-31 ^ '3 0� OZ Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-l. For calculating furred walls use the Mass and Furring Construction table below. Registration Number Registration DatelTime HERS Provider 2008 Residential Compliance Fortes A -larch 2010 A Prescriptive Certificate of Compliance: CF -1 R 'A 1)1) Residential Additions (Page 2 ol'5) Site Address: 1D3 T��/IVIIe4 W14>- V,nforcemewl %gency: Dale: &uNCR r//No, c<y j 6' - 2Z) 1. bor Tug/1D indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roof/Ceiling, 6Valls, Floors, Slabs, Crawl Spoce, !)cors and etc... Indicate in column (; 1he 1-r(uue material and Size. For Wood, Afetal, Metal Buildings, Afass, enter 2x4, 26, or etc... see JA4 Jnr other possible frame rvpe assemblies 3. Enter the thickness for mass in inches or Spacing between framing memhers enter, 16''or 24 "0C; or 01her far all other a.s_s<•mhA drsrrq,r:�ur such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel, and etc... 4. Based on the Climate Zone; enter the equivalent U factor found in JA4 Table based on the R - Value from Table 151-C 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter 7. Enter the Continuous Insulation R -value jor the proposed assembly; otherwise, enter "0 ". 8. Enter the row and column of the Ufaetor value based on Column F Table Number and enter the Assembly U factor in Column J. 9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply. FURRING STRIPS CONSTRUCTION TABLE FOR MASS WALLS ONLY A I B I C I I D I E F I G I If 1 I 7 J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation SauT>s' 9 WIAIVDI.vS Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5 4.3.6 4.3.7 Joint Appendix Table 4.3.13 1. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration area may be the glass area plus a "2 inch frame " around the glass. 2. Enter value from Component Package D Requirements in Table 151-C. 3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower SHGC value than that specified on the Fenestration Proposed Area table above. 4. Submit a completed WS -3R Form ifa reduced SHGC is calculated with exterior shading. S. If a icable at this stage enter "NFRC"for NFRC Certified windows or CEC "Default" values ound in Table 116-A or B. aU U Assembly w ] `o .o .� ° W > �+ Final Mass Name or JA4 Table $ -9 AssembV7, Thickness'T Numbers > Q > U -factor Comment 1. Indicate the Mass Thickness from Reference Joint Appendix JA. 2. Indicate the Assembly Name or type: Roof/Ceiling Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate the Frame type and Size: For Wood, Metal, Metal BuildiW, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the Table number that closely resembles the proposed assembly. 4. Enter the row and column of the U factor value. S. Enter the Effective R -value listed in the J44 Table Number. 6. The Final Assembly is calculated by using Egttation 4-1 or Equation 4-4 of the Reference Joint Appendix JA4. Enter the value in Column L. Z Insert the FinalAssembly U- actor value back on to the Opaque Surface Details table in Column J. FENESTRATION PROPOSED AREAS Fenestration Type and Frame indow, Glass Door or Skylight) Orientation (North, East, ProposedArea' Maximum Maximum NFRC or SOUA West(ft) U -factor" SHGC2• 3.4 Default Values' W/ND`:PWS A14,f7r5' /i,: C vY/NDowS SauT>s' 9 WIAIVDI.vS WeS7- D Total 3!9 OA<< 72 1. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration area may be the glass area plus a "2 inch frame " around the glass. 2. Enter value from Component Package D Requirements in Table 151-C. 3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower SHGC value than that specified on the Fenestration Proposed Area table above. 4. Submit a completed WS -3R Form ifa reduced SHGC is calculated with exterior shading. S. If a icable at this stage enter "NFRC"for NFRC Certified windows or CEC "Default" values ound in Table 116-A or B. Registration Number: Registration Date/Time _ HERS Provider. 2008 Residential Compliance Forms Afarch 2010 Prescriptive Certificate of Compliance: (",F - I It AI)1) Residential Additions (Pa gc 3 of S) Site Address: /D3 ����r�j W1,4 y Enforcement A(,,enc}: I)atc: PE/? 7'11Vo ADDITION ALLOWED FENESTRATION AREAS Check applicable bas belaw if the roof addition is exempt from the roofingproduct "Cool Roof' requirements. Note: If arty one of the boxes are A (3 C D less than 5lb/ft2. Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the above Cool Roof criteria Roof constructions that have thermal mass over the roof membrane with at least 251b/ft2 is exempt from the above Cool Roof criteria. Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, check CFA of Addition AI lOWECI i Allowed ACLU Area �ZCm�" Oe'd� Maximum Allowed Area Aged Proposed Area Thermal ft2 of Cf A (A x I5)fl' < 51b1fe >_ 51b/11:2 (C D) Reflectance" (Table Above) Total Fenestration Area 360 0.20 72 15- ! Z S ® West Fenestration Area 1.4 0 0.05 0 ® [3 (Required In CZ's 2, 4 & 7 -15) E4 0 1. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12. 2. Glass removed to make way for the addition. 3. For additions less than 1,000/ the standards allows glazing removed during the remodel to be added to the glazing area allowance. The maximum allowed glazing area for the addition is the CFA x 20% + glass removed to make way for the addition. 4. In climate zones 2, 4, 7-15, no more than 5% of the CFA is allowed for west facing glazing plus west facing glass area removed to make wa.v for the addition. The maximum allowed west facing glazing area is the CIA x 5% + west facing glass removed to make way for the addition. 5. To meet compliance, the ProposedArea must be less than orequal to the Total Allowed Area for BOTH the Total and West Fenestration Areas. ROOFING PRODUCTS (COOL ROOFS) §Isiwn 2 Check applicable bas belaw if the roof addition is exempt from the roofingproduct "Cool Roof' requirements. Note: If arty one of the boxes are checked below, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(1) are not applicable. Do not full table below. Ll Roofing compliance hQj Required in Climate Zones 1-12, 14, and 16 with a Low -Sloped Less or 2:12 pitch. Woofing compliance Not Required in Climate Zones I through 9 and 16 with a Steep -Sloped. Roofs pitch greater than 2:12 and product weight less than 5lb/ft2. Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the above Cool Roof criteria Roof constructions that have thermal mass over the roof membrane with at least 251b/ft2 is exempt from the above Cool Roof criteria. Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, check the applicable box below if Exempt from the Roofing Products "Cool Roof' Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Numbers <_ 2:12 > 2:12 < 51b1fe >_ 51b/11:2 Type 2 Reflectance" Emittance SRI © 1 0 © ® 04 0 ® [3 © E4 0 ® 0 © ❑4 © ® ® ® ❑4 ® 1 o a 0 a4 ® 1 0 © ® 124 I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www, cool roots. org/oroducts/search. phD. 2. Indicate the type of product is being used for the roof top, i. e. single ply roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(pu„ umt — 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at htta://www, energy.ca.gov/titleX and enter the resulting value in the SRI Column above and attach atopy of the SRI- Worksheet to the CF -1 R. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §1 18(i)4. Select the applicable coating: M Aluminum -Pigmented Asphalt Roof Coating FOCement-Based Roof Coating [] Other Registration Number: Registration Dcue,'Time: _— _ _ _ _ IIERS'Provider: 2008 Residential Compliance Forms it [arch 2010 Prescriptive Certificate of Compliance: CF - I It AI)1) Residential Additions (Page 4 of -5) Site Address: 4d3 7_,(,1A11r,4 WAY Enforcemcnt.kvency: 1)atr: C 41PeW r/A/0 ,Gni IiVAC SYSTEMS - IiEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be Cooling Equipment Type and Capacity 1,2 Duct or kitchens and on all und*erWground hot water pipes is required in all cora Hent cka es in all climate zones. ('ontiguration YES I [3NO7 Slab edge insulation required for heated slabs in all Climate Zones. See details in Table 11 8-A of the standards. Minimum Distribution Piping 0 NO (Central, Split, Heating Equipment Efficiency i'ype and Insulation "i'hermostat Space, package or Type and Capacity'-'-' (AME or ttSIT) Location' R -Value Type I l -dronic) F�iQNAe_- �5 /�-/Z ducts ate; 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.) 2. Recirculatingsystems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do 1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.) 2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i. e., if total capacity < 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(6)3 exception. 3. Refer to the HERS Verification section on Pages 3 and 4 of the CF -IR -ADD Form for additional requirements and check applicable boxes. 4. Indicate Type or Location Ducts, Hydronic in Floor, Radiators, etc. HVAC SYSTEMS - COOLING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be Cooling Equipment Type and Capacity 1,2 Configuration Minimum Distribution Duct or Piping (Central, Split, Efficiency Type and Insulation Thermostat Space, Package or SEERIEER or COP)Location R -Value Type H dronic kitchens and on all und*erWground hot water pipes is required in all cora Hent cka es in all climate zones. Heated Slab Insulation YES I [3NO7 Slab edge insulation required for heated slabs in all Climate Zones. See details in Table 11 8-A of the standards. Raised Slab Insulation 1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc). 2. Refer to the HERS Verification section on Pages 3 and 4 of the CF -/R -ADD Formfor additional requirements and check applicable boxes. 3. Indicate Tpe or Location Ducts, H ronic in Floor, Radiators, etc. WATER HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be storage gas or propane frret4 non-necirrulating, and may not exceed 50 gallons. If no natural gas is connected to the building, an electric storage DHW heater less than 50 gallons with an energy factor greater than 0.90 maybe used Hot water pipe insulation from the DHW heater to the kitchens and on all und*erWground hot water pipes is required in all cora Hent cka es in all climate zones. Heated Slab Insulation YES I [3NO7 Slab edge insulation required for heated slabs in all Climate Zones. See details in Table 11 8-A of the standards. Raised Slab Insulation 0 YES 0 NO External Tank Water Heater Type/Fuel TVDe1 Distribution Type (Standard, Recirculating) 2 Number In System Tank Capacity al Energy Factor or Thermal Efficiency Insulation R -Value' ST�NLRD ONF- �'O o. S26 /�-/Z 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.) 2. Recirculatingsystems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The water heating tank andpipes shall be insulated to meet the requirements o 150. . SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written justification and documentation and special verification. Applicable special features shall be marked with a YES and be Pied within the plans. Radiant Barrier (Roof) NO Re uired in Climate Zones 2, 4, and 8-15 for additions larger than 100 ft z. Slab Edge (Perimeter) Insulation YES 171 NO In Climate Zone 16 under Component Package D, R-7 insulation is required. Heated Slab Insulation YES I [3NO7 Slab edge insulation required for heated slabs in all Climate Zones. See details in Table 11 8-A of the standards. Raised Slab Insulation 0 YES 0 NO In Climate Zones 1, 2, l 1, 13,14 & 16 R-8 insulation is required, and in Climate Zones 12 & 15 R4 insulation is required under Component Package D. Thermal Mass - To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach. Registration Number: _ Registration Date/Time: _._ HERS Provider: _ __ _ 2008 Residential Compliance Forms tlarch 2010 Prescriptive Certificate of Compliance: CF - I R AI)1) Residential Additions ( Pa ge -5 of 5) Site Address: W,:I- y Enforcement Agency: Uale: HERS VERIFICATION SUMMARY - "fhe enforcement agency should pay special attention to the 11FRS Measures specified in this checklist below, A completed and signed CFAR Donn for all the measures specified shall be submitted to the building inspector before final inspection. Duet Sealin & Testing !HERS verification is re uired or this measure. ❑YES ❑i NO In all Climate Zones, if a new space -conditioning system (I IVAC equipment and dueling) is installed to serve the addition alone, the ducts are to be sealed and tested per § 151(f)10. OYES In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are instal led in unconditioned ❑NO space to serve the addition, the ducts are to be sealed and tested per §I52(b)ID. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed insulated or sealed with asbestos. In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) and will serve the addition, the ducts are to be sealed and tested per §152(b)IE. ❑YES ONO ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through ITERS verification in accordance with procedures in the Reference Residential Appendix RA3. © EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. EXCEPTION: Existing duit systems constructed insulated or sealed with asbestos. Refri erant Cha e - Split System HERS verification is_re uired or this measure. ❑YES aN0 In Climate Zones 2 and 8-15, if a newly ducted split A/C or heat punnp is installed to serve the addition alone, a refrigerant charge measurement shall be verified per § 151 7A. In Climate Zones 2 and 8-15, if the existing HVAC equipment is replaced (including replacement of the air handler, outdoor YES ©NO condensing unit of a split system, cooling or heating coil, or the fiumace heat exchanger) and will serve the addition, a refrigerant charge measurement shall be verified per § I52 1 F. Central Fan Integrated Ventilation System — Airflow and Fan Watt Draw - do not apply for additions 1,000 ft2 or less. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow and Fan Watt Draw HERS verification is required. ❑YES ❑NO In Climate Zones 10 through 15, if a new space -conditioning system (HVAC equipment and ducting) is installed to serve the addition alone the airflow and fan watt draw shall be verified per §151(f)7B. DYES nNO In Climate Zones 10 through 15, if the existing space -conditioning system (HVAC equipment and ducting) is replaced and will serve the addition, the airflow and fan watt draw shall be verified per § 152 1F. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is acc r a complete. Name: Signature: Company: Date: Address: If Applicable EA or 02EPE (Certification #): City/State/Zip:- f--�/ f/r Phone: 4345 �✓�!b79'!;-'" % Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The building design feahm identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: �/L •e./CS Signature: Company: Date: Address: a O S !d A,4/QI A/ 4 V�. License: City/State/Zip:: i 1 ^ Y WARD , 6A % � Phone:/_ 4)7�S a For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registration Number: _ _ _ Registration Date.7lme: . _ TIERS Provider: 2008 Residential Compliance Norms Alarch 2010 IMandatory ;Pleasures Summar, ."'NIF-1 R Re's i(ICIt( ial (1'ac(' I nl3) Sile Address: CD3 TQA//Enforcement Af,enc}: �u P,572 Tii+/o z -o - / NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandolog, nreasio cs hsw(> regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CI"=11r, CF -IR -ADD, or CF -IR -ALT Fornt) shall supersede the items marked with an asterisk (*) below. This Mandatory Alcasurer Summary shall be incorporated into the permit documents and the applicable features shall be considered by all parties as nrtninnrm component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -IR Form with plans. DESCRIPTION Building Envelope Measures: 11 a 1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. § 116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC and infiltration that meets the requirements of § 10-111 (a). §117: Exterior doors and windows are weather-stri • all joints and penetrations are caulked and sealed. §118(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form. § 118(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of § 118(i) when the installation of a Cool Roof is specified on the CF -1R Form. *§150(a): Minimum R-19 insulation in wood -frame cading or equivalent U -factor. 150(b): Loose fill insulation shall conform with manufacdura's installed design labeled R -Value. '§150(c): Minimum R-13 insulation in wood -flame wall or equivalent U -factor. *§ I Wd): Minimum R-13 insulation in raised wood -frame floor or equivalent U -factor. §150(f): Air retarding is tested, labeled, and installed according to ASTM E1677-95(2000) when specified on the CF -IR Form 15 Vapor barrier installed in Climate Zones 14 or 16. § 150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 03%; water vapor permeance rate is no greater than 2.0 and shall be pirotected from physical damage and UV light deterioration. FYreplacm Decorative Gas Appliances and Gas Log Measures: § (50(e)1 A Masonry orfactory4milt fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)IB: Masonry or factwy4x& fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a with a readfly acoesuble, operable, and tight -fitting damper and or a combustion -air control device. §150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Spam Condloonlu& Water Heatin and Plumbing System Measures: 110- 113: HVAC equipment, water linters, showerheads, fatxxts and all other regulated appliances are certified by the Energy Commission. §113(c)5: Water heating recirculation loops saving multiple dwelling units and High -Rise residential occupancies meet the air release valve, backflow prevention, pump isolation valve,and recirculation loop connection requirements of § 1 13 c 5. § 115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt),and pool and spa heaters. § 150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACOA. § 150(i): Heating ms are equipped with thermostats that meet the setback requirements of Section 112(c). §150(j)IA: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. § 150(j)1B: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. § I50(j)2: First 5 fat of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-B. § 150(j)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. § 150(j)2: Pipe insolation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards TabIr 123-A. § 150(j)3A: Insuk 1 is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. § 150(j)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. 2008 Residential Compliance Forms August 2009 Mandatory Measures Stlmnlary IZesidential ff':I_,c 2 of .3) SileAddrese /f13 %pN�TA G(/,G)y I;nforcemenlle: §150(j)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Ucrtillcition Corporation. Ducts and Fans Measures: § I50(m)l : All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sectimis 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 inch, the combination of mastic and either mesh or tape shall be used § 150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain. ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. § 150(m)2D: Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. § 150(m)7: Exhaust fan systems have back draft or automatic dampers. § 1 50(m)8: Gravi ventilating ms serving conditioned space have either automatic or readily accessible, manually operated dampers. §150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with coating that is water retardant and provides shielding from solar radiation that can cause degradation of the mawisl. § I50(m)10: Flexible ducts cannot have porous inner cores. §150(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptablelndoor Air Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa HeathK Systems and Equipment Measures: §114(a): Any pool or spa beating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations; an on-off switch mounted outside of the heater, a permanent weatherproof plate or card with operating instructions; and shall not use electric resistowe beating or a Pilot fighL § 114(b)l: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return Imes,or built connections for future solar beating 11 : Outdoor pools or spin that have a heat pump or gas beater shal I have a cover. § 114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or programmed to run only during off electric demand periods. §15 ): Residential pool systems or equipment meet the pump sizing, flow rate, pipin& filters, and valve requirements of § 150(p). Residential Lkbdft Measures: § 150(k)l: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-0 and is not a low efficacy luminaire as specified by § I S 15 The wattage of permanently installed luminaires shall be determined as specified by § 130(d). 150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz § 150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line -voltage lamp holder, OR shall be rated to consume no more than five watts of power as determined by § 130(d), and shall not contain a medium screw -base socket § 150(k)6: Lighting integW to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k). § 150(k)7: All switching devices and controls shall meet the requirements of § I50(k)7. § 150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 f or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 500/9 high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a manuals occupant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet §150(k)10: Permanently installed luminaires in bathrooms, attached and detai.h,-d garages, laundry rooms, closets and utility rooms shall be high efficacy. 2008 Residential Compliance Forms August 2009 Mandatory Measures Summary iINIIF-I R Residential (Page 3 of'3) Site Address: /193 TO 17'_A W41Y Enforcement Agency: I)afc: z` EXCEPTION l: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on occupant sensor certified to comply with the applicable requirements of § 119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual -on occupant sensor. §150(k)l 1: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of § 119, or by a manual -on occupant sensor that complies with the applicable requirements of § 119. EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply with § 150(k) 11. §150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing and ceiling. §150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management control system (FMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptionl to § 150(k)13 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not be high efficacy luminaires. § 150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five watts of power as determined according to 13 § 150(k) l5: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of Sections 130 131, 134 and 146 § 150(k)l6: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensor(s) certified to comply with the applicable requirements of § 119. 2008 Residential Compliance Forms August 2009 CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(c)cupertino.org PURPOSE: The 2013 CalGreen Code applies to all newly constructed hotels, motels, lodging houses dormitories, condominiums, shelters, congregate residences, employee housin�?? It ousing and other types of swellings with sleeping accommodations and new accessory bu Vassociat with such uses. Existing site and landscaping improvements that are not otherwise disturbed areVqt lbct to the requirements of CALGreen. Project Name: John VBnSChaaCk Project Address: I 'F , . 76 TonitC eltino CA 95014 Building Department Project Descripti d ItlOn ��� i $UBMITTAL Instructions: PEVIEV;FD FUR COUE GOMPLiANCF ff ti 1. The Owner or the OJdftIti��Vshaj:�"Ioy,44ed professional experienGCd 4th the California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional §h II complete Column 3 and sign and date Section 2 - Implem ntation Ver' is ion at tend of this checklist and submit the completed form to the Building Inspe tr. e' Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Reauirements Rlaming end Design y Site Devellopment 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during ❑X ❑ construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ® ❑ site grading or a drainage system will manage all surface water flows. Page I of 5 CalGreen_2014.doc revised 01/15114 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. 0 11 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.doe revised 01%15/14 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. El ❑ ❑ 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. 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables, i 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. 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. 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building �X occupant or owner. 4.503.1 General. Install only a direct -vent sealed -combustion gas or sealed wood -burning fireplace, or a sealed woodstove. MX 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. 11 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be Ezil 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 0 compounds. Page 3 of 5 CalGreen_2014.doc revised 01115114 4.504.2.4 Verification. Documentation shall be provided to verify that El VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with 11VOC 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 (CHIPS) Low -emitting ❑X ❑ 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 ❑X ❑ comply with low formaldehyde emission standards. 4.505.2 Concrete slab foundation. Required vapor retarders and capillary ❑ breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building ❑ materials used in wall and floor framing is checked before enclosure. 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the 1:1building are provided in every bathroom. 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. 702.1 Installer training. HVAC system installers are trained and certified in ❑ ❑ the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the ❑X ❑ discipline they inspect and verify. 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 01115/14 Project Name: Project Address: CALGREEN SIGNATURE DECLARATIONS Vanschaack Project 10376 Tonita Way, Cupertino CA 95014 Project Description: Addition 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 Signature Date Design Prof 'onal's Name (P se Print) a/7 Signature of License Professional responsible for CalGreen compliance Date lid ! SOLA V r 1l0f-1 c 40,E --.260 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 alifor1m Green Buil ng Standards Code as adopted by the City of Cupertino. d 46 - /,4 Signature of License Professional responsible for CalGreen compliance Date lKQ l 4// x/t2 fC JIOS— 60-,M Name of License Professional responsible for CalGreen compliance (Please Print) Phone VX L€RI1 A�'/KCALIC, - CsC - C^%f'i't Email Address for License'Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2014.doc revised 01/15/14