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13060180CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21330 VAI AVE CONTRACTOR: ANTHONY HODDER PERMIT NO: 13060180 CONSTRUCTION OWN'ER'S NAME: CAROL MARIDON 7504 BOLLINGER RD DATE ISSUED: 08/[6/2013 OWNER'S PHONE: 4089731913 CUPERTINO, CA 95014 PHONE NO: (408) 257-4317 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ CONSTRUCT 670 SQ FT OF ONE STORY ADDITIONS; License Class Lie. # INTERIOR REMODEL (208 SQ FT). Contractor Date REV # 2 - COFFERED CEILING IN KITCHEN & LIVING RM 1 hereby affirm that I am licensed under the provisions of Chapter 9 - ISSUED 2/28/14 (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: $232100 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 36205030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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 to building construction, and hereby authorize representatives of this city to enter WITHIN 180 �-s-6F, IT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save �$9 R _ LL,ED INSPECTION. indemni and keep harmless the Cit of Cupertino against liabilities, ud ents, f} p Y p b J gm� costs, and expenses which may accrue against said City in consequence of the ., / ��.����" J by: Date: granting of this permit. Additionally, the applicant understands and will comply sued with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 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) /as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sea.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 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 1 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 Cu ertino Municipal Code Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Secti 5505, 533, a4 255 Section 3700 of the Labor Code, for the performance of the work for which this / Owner or authorized agefythat l is issued. in the performance of the work for which this permit is issued, I shall Ft mploy 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, 1 CO ' CTION 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 1 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. t understands and will comply granting of this perttµt.- 11 the the aX"u with all non-pointre lation ertino Municipal Code, Section Licensed Professional 9.18. �� Signature I/ II CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building Gacupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI Ik REVISION / DEFERRED ORIGINAL PERMIT # D PROJECT ADDRESS (� / a U OC APN # 367, 67, OWNER NAME n� ' Co PHONE e 8 T I ?3- /q/3 E-MAIL -vol , l a y- 1 y STREET ADDRESS CITY, STATE, ZIP , 7FA�__ �o a. v CONTACT NAMEPHONE �. • FrMAM II� I . C — °� ZC-4 C76 .0 o leo o-.« c STREET ADDRESSY ( 03 O X ^ CITY, STATE, ZIP 0 FAX ❑ OWNER ❑ OWNFR-BUILDER q OWNER AGENT ❑ CONTRACTOR 7(CONTRACTOR AGENT ❑ ARCHnECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONFrRACTOR NAME LICENSE NUMBER l 7 z LICENSE TYPE y) BUS. LIC # � N U G/ � (�> J COMPANY NAME E-MAIL ( r FAX Fv 4N GtC F__i2 STREET ADDRESS 4/ CITY, STATE, ZIPO / PHONE ARCHITFCT/ENGWEE NAME LICENSE NUMBE�_ / BUS. LIC # eU . COMPANY NAM(, .. MAIL E-MAIL r��,� Za�� FAX v5� l��.Z ���., 13z� STREET ADDRESSyo�S I Z � �✓e •Gtr ! c � a CITY, STATE, ZIP / PHONE D QF EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA A BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA ""' REMODEL AREA PORCH AREA DECK AREA AL DECK/PORCH AREA GARAGE AREA: LJ DETACH ❑ ATTACH # DWELLING UNITS IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEINCADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL# []NO PLANNING APPROVAL LEITER IS THE BLDG AN ❑ YES EICHLER HONIE? []NO I�� � �, �1 ✓,�: n)I�� �N%, .,,....F- r i f � � By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b=nsa orize representatives of Cupertino to enter the above -identified property for inspection purposes. Date: � Signature of Applicant/Agent: RMATION QUIRED�ii�IG>tiXr SUPPLEMENTALVinggs,: New SFD or Multifamily dw Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. P - Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. Copy of Planning Approval Letter or Meeting with Planning Prior to _ submittal of Building Permit application. 1�o,G �r �i BldgApp_201 T doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District.etc.). These fees are based on the nreliminary information available and are only an estimate. Contact the DeDt for addn'l info. FEE ITEMS (Fee Resolution I1-053 Eff 711/I3) ADDRESS: 21330 VAI AVE DATE: 02/28/2014 REVIEWED BY: MELISSA APN: 326 05 030 BP#: 13060180 'VALUATION: $0 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 0.0 PENTAMATION PERMIT TYPE: WORK REV # 2 - COFFERED CEILING IN KITCHEN & LIVING RM - ISSUED 2/28/14 SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District.etc.). These fees are based on the nreliminary information available and are only an estimate. Contact the DeDt for addn'l info. FEE ITEMS (Fee Resolution I1-053 Eff 711/I3) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. Q OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 7T_ 0 F) Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 Strom, Motion Fee: $0.00 1.0 hrs $139.00 Inspections ISTTNSP Inspection, Hourly B1d Stds Commission Fee: $0,00 SUBTOTALS- $0.00 $139.00 TOTAL FEE: $139.00 Revised: 01/15/2014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21330 VAI AVE CONTRACTOR: ANTHONY HODDER PERMIT NO: 13060180 CONSTRUCTION OWNER'S NAME: CAROL MARIDON 7504 BOLLINGER RD DATE ISSUED: 08/16/2013 OWNER'S PHONE: 4089731913 CUPERTINO, CA 95014 PHONE NO: (408) 257-4317 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ 15WCONSTRUCT License Class Lic. it 6--5-23 670 SQ FT OF ONE STORY ADDITIONS; INTERIOR REMODEL (208 SQ FT). Contractor & �' Date E,e /69, REVISIO - REVISE FAMILY RM. COFFEUR CEILING - I hereby affirm that I am licensed under the provisions of Chapter 9 ISSD 12/1 13 (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 followin I have and will maintain a certificate of consent to self -insure for orker's Compensation, as provided for by Section 3700 of the Labor Code,A: T Sq. Ft Floor Area: Valuation: $232100 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 36205030.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. 1 agree to comply with all city and county ordinances and state laws relating WITMN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, lj costs, and expe which may accrue against said City in consequence of the Issued by: Date: /� Ile granting of 's pe it. Additio a applicant understands and will comply ✓ with urce ren er the Cupertino Municipal Code, Section 9.18. Zallnpoint / RE -ROOFS: Sign Da t 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 hereb 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 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. l 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, sho se equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as deli by th Bay Area uality Management District I performance of the work for which this permit is issued. will maintain complia , e with th Cuperti nicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety t ode, Sectio s 255 3, and 25534. �C1� i3 Section 3700 of the Labor Code, for the performance of the work for which thisE'c Owner or authorizedent: ate: 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 CO TRUCTION 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 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING"' #_,.�.B 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 SION (408) 777-3228 • FAX (408) 777-3333 • buildingna,cupertino.org CUP€RTINO ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS ` r ti r C' APN # OWNER NAME iPHONE E-MAIL dO ,J -Co56 20 4 STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME l- PHONE E-NIAJL STREET ADDRESS ` CITY STATE, ZIP ` FAX v ❑ OWNER ❑ OWNER.BuiLDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME i//fLICENSE NUMBERF / LICENSETYPE e BUS. LIC CONIPANYNAME/ E-MAIL / 1 ( FAX 0641 f� C1 A.]_ A STREETADDRESS � J � CITY, ST , C) SII t_J r ARCHITECT/ENGINEER NAMF--/e l/ N Z h LICENSE NUMBER - BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS (�O CITY, STATE, 71P PHONE Yoa -- Y65-13?6 DESCRIPTION OF WORK r USE I TYPE OCC. I SQ.FT. I VALUATION (S) EXISTG NEW FLOOR DEMO TOTALp AREA AREA AREA NET AREA BATHROOM KITCHEN0TH REMODEL AREA REMODEL AREA ITODEL AREA BldgApp_2011.doc revised 06/21/11 ❑ ATTACH . K DWELLING UNITS: S A SECOND UNrr ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PILE -APPLICATION ❑ YFS IF YES, PROVIDE COPY OF IS THE BLDG AV ❑ YES ; R-EgEdYED y, . _ - TOTAL TION: PLA,NNNG APPL# ❑ NO PLANNIING APPROVAL LETTER EICHLER HOME? ❑ NO r By my signature below, ]certify to eg be fol w [ In the property owner or authorized agent to act on the properly owner's behalf. I have read th s application and the information I b ded rr c have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin- o g stiucti I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Siggnawre of Applicant/Agent: Date: PG SUPPLEMENT INFORIv1 ON REQUIRED PLAN cI"zEc a 1 a Rev? z G sI IP° O\ ER THE-COU'�vfER BLIP nI\G I L:4A RE17f �\ New SFD or Multifamil dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. pLAN,�z*+G P* AN RE+�z Rs Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ®sTAND °UB* IC M oRics form if any Hazardous Materials are being used as part of this project. C LARGE;`FIRS DEPT Copy of Planning Approval Letter or Meeting with Planning prior to GI ❑ submittal of Building Permit application. MAJOR i SAhiTARY PD ST iIC7 BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21330 VAI AVE CONTRACTOR: ANTHONY I IODDER PFIRMIT NO: 13060180 CONS IRUC fION OWNER'S NAME: CAROL MARIDON 7504 BOLLINGER RD DATE: ISSUED: 08/16/2013 OWN'ER'S PHONE: 4089731913 CUPF,RTINO, CA 95014 PHONE: NO: (408) 257-4317 LICENSED CONTRACTOR'S DECLARATION BUILDING P'ERMI'T INFO: BLDG ELECT PLUMB License Class. I.ic. .__.. .73 MECH RESIDENTIAL COMMERCIAL Contractor � y � � �.� Dale � 3 I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: CONSI-RUCf 670 SQ F'f OP ONI: STORY ADDfI'IONS: (commencing with Section 7000) of Division 3 of the Business & Professions IN' II;RIOR RGMODGI. (208 SQ 1: 1-) 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 performance of the work for which this permit is issued. f have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $232100 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 36205030.00 Occupancy "Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnily and keep harmless the City of"Cupertino against liabilities judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. With all non-point source regulations per the Cupertino Municipal Code, Section Signature — Date �� Issued by: .: —/Date: . OWNF,R-BUII,DF,R DECLARATION Rf ROOFS: I hereby affirm that I am exempt from the Contractor's License I,aw for one of All roofs shall be inspected prior to any roofing material being installed 11'a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for I, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant Date: 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business & Professions Code). ALL ROOK COVERINGS TO BE: CLASS ",1" OR BhI"h1?R I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate ofConscnl to self-insure for Worker's HAZARDOUS NIATERIAI,S DISCLOSI RE: Compensation_ as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance ofthe work for which this Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Nlanagement District 1 will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance withthe :upertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to bccomc subject to the Worker's health & Safety Code, Sec 25505, 25533, and 25534. Compensation laws of California. Jr, after making this certificate of exemption, I become sub_lect to the Worker's Compensation provisions of the Labor Code, I must deemed OwnC ` r aut nt: Dater_ �'_:� forthwith comply with such provisions or this permit shall be revoked. r` CONSTRUCTION LfV�DING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of' work's correct. I agree to comply with all city and County ordinances and state laws relating for which this permit is issued (See_ 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter bender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs. and expenses which may accrue against said City in consequence of the grantim, of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per (he Cupertino Municipal Code, Section 9.18 1 understand my plans shall be used as public records Signature Date Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 ' FAX (408) 777-3333 • buildin cu eTtinO.Or ❑ NEW CONSTRUCTION „ADDITION ❑ ALTERATION / TI ❑ REVISION/ nEFERRED ORIGINAL PERMIT # PROJECT ADDRESS I 1 a( A v e- APN # OWNER NAME _ r O I�/i a r i JO P74 Q/ T71L �3 /9/ STREET ADDRESS Z1350 Vat Ave - CITY, STATE, ZTP ,,r4,.W0 (,:N tittle FAX CONTACT NAME I f Z+' MAIL 1 PHONE.40 8-&56-20 STREET ADDRESSU „ 3 bx p� Q CLTY, STATE, ZIP ml Q FAX ❑ OWNER ❑ OWNER -BUILDER X OWNER AGENT ❑ CONTRACTOR AONI'RACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAMEON, LICENSENUMBERgf( 67 LICENSE TYPE BUS. LIC# O� COMPANY NAMEE-MAIL d C'o,v keAjo rria; cOM FAX ,- STREET ADDRESS T6 .1H , CITY, S TE, ZIP /; NQ �a • PHONE BUS LIC # ARCHITECT/ENGINEER NAMEC'J2 j LICENSE NUMBER / h COMPANY NAME E-MAIL �c� FAX N ; r e 7�G ✓c r , Co STREET ADDRESS/�O ! JAY/ CITY, STATE, ZIPsar4A PHONE 0�^ I3 ' /��( C v • F DESCRIPTION OF WORK d OF lAA, A 4—, l 0rJ Z. EXISTING USE PROPOSED USE CONST -TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECKMORCH AREA GARAGE AREA: LJDETACH Q ATTACH N DWELLING UNITS: -is -A SECOND UNIT ❑ YES SECOND STORY ❑:YES BEING ADDED? ❑NO ADDITION? QNO t PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF tS THE BLDG AN 1:1YES f TOTAL VALUATION: PLANNING APPL 9 [ NO PLANNING APPROVALLETTER EICHLER HOME? ❑. NO 2 , too (this By my signature below, I certify to each of the following: I am the property owner or thor' ct on e perty owner's behalf. I have read application and the information I have provided is correct. l have read the Description of Wor erify it i rate. 1 agree to comply with all applicable local ordinances and state laws relating to b ' g co tru on. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: ieA✓G SUPPLEMENTA NFORMAT N REQUIRED PLAN CHECK TYPE ROUTING SLIP ¢ TxEtaR aurY nIxGPLAN REvrW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS- Cl PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ANDARO PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. 0 LARGE Q FIREDFFT Copy of Planning Approval Letter or Meeting with Planning prior to p MAJOR ❑ SANITARY SEWER atSTRICT submittal of Building Permit application. C� ENVIRONMENTAL HEALTH BldgApp_201l.doc revised 06121111 M/h CITY OF CUPERTINO f FEE ESTIMATOR - BUILDING DIVISION 1AADDRESS: 21330 VAI AVE DATE: 06/21/2013 REVIEWED BY: MELISSA PC FEE ID APN: 362 05 030 BP#: 06 *VALUATION: 1$232,100 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? Yes % No OTC. 0 Yes © No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK 1661 S. F. ADDITION TO ENLARGE E KITCHEN FAMILY RM MASTER BDRM & BATH. REMODEL SCOPE 1770 S.F. INCLUDING ENTRY, DINING RM, KITCHEN & FAMILY RM OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.t. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 661 $2,468.00 IR3PLNCK $1,549.00 IR3INSP PME Plan Check: $0.00 Permit Fee: $1,549.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 661 $2,468.00 $1,549.00 'W" ��� �?1 �� , ' ' '�� �,, �, � % x „ • ! ,, ;LIQ` ��IUI�>�,'Y/,, l�,°F:lr, lIre°J E,'1rr:c�k !"Fre�rrfJ. 1'irnr � Irc�cF, fl��G 1'lren (`arr.>��/� $2,468.00 770 s.f. $534.00 Remodel, Other IREMRESOTH i)P lcf. rLldr� 61.Li Suppl. PC Fee: E) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: NOTE: This estimate does not include fees due to other Departments (i. a Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimates Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,468.00 770 s.f. $534.00 Remodel, Other IREMRESOTH Suppl. PC Fee: E) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,549.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C ofI",o—II+. tion 1 1. N. E) Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: IPLLONGR $85.93 Select a Non -Residential Building or Structure 0 0 A Strong Motion Fee: IBSEISMICR $23.21 Select an Administrative Item BldgStds Commission Fee: IBCBSC $10.00 $4,136.14 $534.00 , ,,.v $4,670.14 �\ Revised: 04/29/2013 A \�1 . . ....... .... . .. CUPERTINO DwBrtmPmt ADDITION TO EITZEN RESIDENCE 21330 VAI AVE. CUPERTINO, CA 95014 TITLE 24 ENERGY REPORT FRI ENERGY CONSULTANTS, LLC TITLE 24 ENERGY CONSULTANTS 21 N. HARRISON AVE. CAMPBELL, CA. 95008 408-866-1620 FAX: 408-866-6832 EMAIL: info@friconsuIting.com,-,, 1. 7 BUILDING ENERGY ANALYSIS REPORT -I PROJECT: Eitzen Residence 21330 Vai Ave. Cupertino, CA 95014 Project Designer: Steve Benzing, Architect 12405 Fredericksburg Saratoga, CA 408-867-6910 Report Prepared by: Nicholas L Bignardi R08-11-2009 FRI Energy Consultants, LLC 21 N. Harrison Ave Suite 210 Campbell, CA 95008 408-866-1620 Job Number: 0130341 Date: 6/18/2013 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresldential 2008 Building Energy Efficiency Standards. This program developed by Energy5oft, LLC — www.energysolt com. EQUIPMENT LIST AND INSULATION PLACEMENT NOTE ADDITION FOR EITZEN RESIDENCE 21330 VAI AVE. CUPERTINO, CA 95014 #0130341 NOTE: MINIMUM HEATING AND COOLING LOAD CALCULATIONS ARE GENERATED BY THE COMPUTER PROGRAM. THERE ARE OTHER DESIGN FACTORS THAT MUST BE CONSIDERED, DUCT FLOW, COIL SIZING, OVERSIZING SAFETY MARGIN, ETC. IT IS THE RESPONSIBILITY OF THE MECHANICAL CONTRACTOR OR WHOEVER DESIGNS AND INSTALLS THE HEATING AND COOLING SYSTEM TO MAKE THE FINAL DECISION ABOUT THE SIZE OF THE EQUIPMENT TO BE INSTALLED. THE HVAC EQUIPMENT USED MUST MEET THE EFFICIENCIES SHOWN IN THE TITLE 24 CALCULATIONS. THESE ARE AS FOLLOWS: HEATING: NEW FURNACE(S) MUST HAVE AN AFUE OF .80 OR BETTER. FURNACE(S) MUST BE ABLE TO HANDLE THE HEATING LOAD. AIR CONDITIONING: IF AIR-CONDITIONING IS TO BE INSTALLED, IT MUST HAVE A MINIMUM SEER OF 13. SETBACK THERMOSTAT: A SETBACK THERMOSTAT IS REQUIRED FOR EACH NEW FURNACE. WHOLE HOUSE VENTILATION REQUIREMENTS: 2008 CEC RESIDENTIAL STANDARDS VENTILATION FOR THIS PROJECT NOT REQUIRED PER RULE SEC. 4.6 EXEPTION 5 TO SECTION 152 (a) . HOT WATER HEATER: WE SHOW A 50 -GALLON WATER HEATER IN OUR CALCULATIONS. THE FIRST 5 FT. OF PIPES FROM THE STORAGE TANK MUST BE INSULATED WITH ONE INCH OF INSULATION FOR BOTH HOT AND COLD WATER PIPES. NEW PIPES FROM THE WATER HEATER TO THE KITCHEN THAT ARE 0.75 IN. OR LARGER MUST BE INSULATED WITH ONE INCH OF INSULATION. TABLE 150-B PIPE INSULATION MINIMUM THICKNESS REQUIREMENTS FAUCETS AND SHOWERHEADS: SHOWERHEADS AND FAUCETS MUST BE ON PIPE DIAMETER Less than or Equal to Greater than 2 inches 2 inches INSULATION THICKNESS REQUIRED (in SYSTEM inches Domestic hot water (above 105°F) 1.0 1.5 Hydronic heating supply lines (above 200°F to 250°F) 1 1.0 2.0 Hydronic heating supply lines (105°F to 200°F 1.0 1.5 Cooling system refrigerant suction, chilled water and brine lines 0.75 1.0 1 Steam hydropic heating systems or hot water systems with pressure above 15 psi shall meet the requirements of TABLE 123-A. FAUCETS AND SHOWERHEADS: SHOWERHEADS AND FAUCETS MUST BE ON THE CEC APPROVAL LISTING IN ORDER TO BE INSTALLED. THIS CAN BE CHECKED THROUGH THE BUILDING DEPARTMENT ISSUING THE BUILDING PERMIT, THE CALIFORNIA ENERGY COMMISSION 916-654-4080, OR BY CALLING OUR OFFICE 408-866-1620. INSULATION PLACEMENT: INSULATION TO BE INSTALLED MUST MEET CEC QUALITY STANDARDS. FOR GLAZING U -FACTORS AND SHGC VALUES REFER TO THE CF -1R OF THE REPORT. NOTE: ALL R -VALUES AND U -VALUES LISTED ARE MINIMUM VALUES AND CAN BE EXCEEDED. LIGHTING: PERMANENTLY INSTALLED LUMINARIES LOCATED IN BATHROOMS, GARAGES, LAUNDRY ROOMS, AND UTILITY ROOMS SHALL BE HIGH EFFICACY LUMINARIES OR LOW EFFICACY CONTROLLED BY A MANUAL ON AUTOMATIC OFF OCCUPANT SENSOR(S) CERTIFIED TO COMPLY WITH SECTION 119(D) PERMANENTLY INSTALLED LUMINARIES LOCATED IN ROOMS OTHER THAN IN KITCHENS BATHROOMS, GARAGES, LAUNDRY ROOMS, AND UTILITY ROOMS SHALL BE HIGH EFFICACY LUMINARIES (EXCEPT CLOSETS LESS THAN 70 FT) OR LOW EFFICACY BULBS CONTROLLED BY A DIMMER SWITCH OR BY AN MANUAL ON AUTOMATIC OFF OCCUPANT SENSOR THAT COMPLIES WITH SECTION 119(d). HIGH EFFICACY LUMINARIES OTHER THAN OUTDOOR HID: CONTAIN ONLY HIGH EFFICACY LAMPS AS OUTLINED IN TABLE 150-C, AND DO NOT CONTAIN A MEDIUM SCREW BASE SOCKET (E24/E26). BALLAST FOR LAMPS 13 WATTS OR GREATER ARE ELECTRONIC AND HAVE AN OUTPUT FREQUENCY NO LESS THAN 20 kHz LUMINARIES THAT ARE RECESSED INTO INSULATED CEILINGS MUST BE APPROVED FOR ZERO CLEARANCE INSULATION COVER (IC) AND ARE CERTIFIED TO ASTM E283 AND LABELED AS AIR TIGHT (AT) TO LESS THAN 2.0 CFM AT 75 PASCALS Lamp Power Rating for Non -LED Lighting Minimum Lamp Efficacy for Non -LED (see Note 1), or System Power Rating for LED Lighting, or Minimum System Efficacy for Lighting see Notes 2, 3, and 4 LED Lighting 5 watts or less 30 lumens per watt over 5 watts to 15 watts 40 lumens per watt over 15 watts to 40 watts 1 50 lumens per watt over 40 watts 60 lumens per watt Notes: I- Determine minimum lamp efficacy category for lighting systems which are not LED using the initial rated lumens divided by the rated watts of the lamp (not including the ballast). 2. To qualify as high efficacy, an LED luminaire shall meet the minimum system efficacy requirements in Table 150-C when determined according to Reference Joint Appendix JA8, and be certified to comply with Section 119(m), and input power shall be determined according to Section 130(d)5. 3. For a Hybrid LED Luminaire to qualify as a high efficacy luminaire, all lighting systems in the luminaire shall qualify as high efficacy according to Section 150(k)l, and the LED Light Engine with Integral Heat Sink shall comply with Note 4, below. 4. To qualify as high efficacy, an LED Light Engine with Integral Heat Sink shall meet the minimum system efficacy requirements in Table 150-C when determined according to Reference Joint Appendix JAB, shall be certified to comply with Section 119(m), and input Dower shall be determined accordinp- to Section 13005. WHEN IN DOUBT ABOUT MEETING THIS REQUIREMENT CALL FRI ENERGY CONSULTANTS, 408-866-1620. ALL FLUORESCENT BALLAST MUST BE APPROVED BY THE CEC, THIS CAN BE CHECKED THROUGH THE BUILDING DEPARTMENT ISSUING THE BUILDING PERMIT, THE CALIFORNIA ENERGY COMMISSION 916-324-3376, OR BY CALLING OUR OFFICE 408-866-1620. ALL REFRIGERATORS, REFRIGERATOR -FREEZERS AND FREEZERS MUST BE ON THE CEC APPROVAL LIST THIS CAN BE CHECKED THROUGH THE BUILDING DEPARTMENT ISSUING THE BUILDING PERMIT, THE CALIFORNIA ENERGY COMMISSION 916-324-3376, OR BY CALLING OUR OFFICE 408-866-1620. l�, SKYLI6�Yf 6, TYP, WAV 12, 6LAZ.IN6 11, CAMNIT U, AVC Wa LIVING 5PAC� 8, FLP, VOV� 64 5, CAM 5WAPMON WALL I, TYP, UfCEILIN6 K PLICT 2, VALUR) WOF W/ ArT AM M 5ppa TYPICAL 4, W WALL 1. TYPICAL FLAT CEILING TYP R-30 INSULATION, BATT OR RIGID 2. VAULTED ROOF W/ATTIC N/A INSULATION, BATT OR RIGID 3. VAULTED ROOF NO ATTIC N/A INSULATION, BATT OR RIGID 4. EXTERIOR WALL TYP R-13 INSULATION, BATT OR RIGID 5. SEPARATION WALL N/A INSULATION, BATT OR RIGID 6. WALL BACKING INTO ATTIC N/A INSULATION, BATT OR RIGID 7. CRAWL SPACE FLOOR TYP R-19 INSULATION, BATT OR RIGID 8. FLOOR ABOVE GARAGE N/A INSULATION, BATT OR RIGID 9. SLAB EDGE INSULATION-' N/A SEE NOTE BELOW 10. BUILT UP ROOF N/A 11. CANTILEVERED FLOOR N/A INSULATION, BATT OR RIGID U -VALUE SHGC 12. GLAZING TYP 0.58 0.65 DOUBLE NON-METAL OR BETTER FRENCH DOORS TYP 0.53 0.65 DOUBLE NON-METAL OR BETTER SLIDING GLASS DOORS TYP 0.53 0.65 DOUBLE NON-METAL OR BETTER 13. SKYLIGHTS N/A DOUBLE NON-METAL,OR BETTER 14. HEATING & COOLING DUCTS MINIMUM INSL. R -VALUE 6.0 1 THE MINIMUM DEPTH OF CONCRETE -SLAB FLOOR PERIMETER INSULATION SHALL BE 16 INCHES OR THE DEPTH OF THE FOOTING OF THE BUILDING, WHICHEVER IS LESS. NOTE: THIS CROSS SECTION IS USED ONLY FOR DIAGRAMMATIC PURPOSES AND IS NOT A TRUE CROSS SECTION OF THIS PROJECT. PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF -1 R Project Name Eitzen Residence Building Type ❑ Single Family O Addition Alone ❑ Multi Famlly ® Existing+ Addlllon/Alteratlon Date 611612013 Project Address 21330 Vai Ave. Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 2,391 Addition 661 V of Stories 1 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ❑ No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form. ❑ Yes it No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Construction Type Area Special Cavity Features see Part 2 of 5 Status Floor Wood Framed w/Crawl Space None 1, 730 Existing Wall Wood Fumed None 386 Existing Roof Wood Framed Attic R-19 1, 730 Existing Floor Wood Framed w/Crawl Space R-19 661 New Wall Wood Framed R-13 940 New Roof Wood Framed Attic R-30 661 New FENESTRATION U- Exterior Orientation Area(' Factor SHCC Overhang Sidefins Shades Status Front (N) 84.4 0.580 0.65 none none Bug Screen New Left (E) 8.0 0.580 0.65 none none Bug Screen Existing Rear (S) 16.0 0.580 0.65 none none Bug Screen Existing Rear (S) 50.0 0.580 0.65 none none Bug Screen Removed Rear (S) 37.4 0.580 0.65 none none Bug Screen New Front (N) 69.0 0.580 0.65 none none Bug Screen Removed Left (E) 24.0 0.580 0.65 none none Bug Screen Removed Rear (S) 53.4 0.530 0.65 none none Bug Screen Removed Right (Wj 36.0 0.580 0.65 none none Bug Screen Removed Front (N) 40.0 0.530 0.65 none none Bug Screen New Left (E) 24.0 0.580 0.65 none none Bug Screen New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER Setback Altered HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status HVAC System ducted ducted Attic, Ceiling Ins, vented 4.2 Altered WATER HEATING Qty. Type Gallons Min. Eff Distribution Status 1 Small Gas 50 0.62 No Pipe Insulation Altered Ener Pro 5.1 by EnergySoft User Number: 1315 RunCode: 2013-06.18T10:36:18 ID: 0130341 Pe e 3 of 13 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-'I R Projeot !*lame Eitzen Residence❑ Building Type ® Single Family ❑ Addition Alone Multi Famlly ® Existing+ AdditioniAfteration Date 6/98/2093 Project Address 21330 VaAve, Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floes' Area 2,391 Addition 669 # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST Yes I] No HERS Measures --If Yes, A CF-4R must be provided per Part 2 of 5 of this form. Yes E]No Special Features --If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavity Features see Part 2 of 5 Status FENESTRATION U- Exterior Orientation Area(fi`) Factor SHGC Overhang Sidefins Shades Status Rear (S) 60.0 0.530 0.65 none none Bug Screen New Right (W 17.5 0.580 0.65 none none Bug Screen New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status HVAC DIISTRIBUTION Duct Location Heatl ng Cooling Duct Location R-Value Status WATER HEATING Qty. Type Gallons Min. Eff Distribution Status ! ner Pro 5.1 by En Soft User Number: 1315 RunCode: 2013-06.18740:36:18 1D: 0130341 Page 4 of 13 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF-1 R ........................................ . project Name Litzen Residence Building Type ® Single Family ❑ Addition Alone ❑ Multi Family p Existing+ Addition/Alteration Dots 6/98/2013 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justifloation and documentation, and special verfficatlon to be used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special Justification and documentation submitted. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF-41R form for each of the measures listed below for final to be given. Erle 1'o 5.1 by EneraySoff User Number: 1315 RunCode: 2013-06-16T10:36:16 !D: 0130341 pe e 5 of 13 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF -1 R Project Nwne Building Type m Single Family ❑ Addition Alone Date Fir°zen Residence ❑ Multi Family m Existing+ Addition/Alteration 611812013 ANNUAL ENERGY USE SUMMARY St8nd8rd Proposed Margin TDV 1<191u/ft2- r Space Heating 50.50 34.96 15.54 Space Cooling 23.65 14.98 8.67 Fans 11.66 8.02 3.63 Domestic Hot Water 17.67 16.46 1.21 Pumps 0.00 0.00 0.00 Totals 103.48 74.43 29.05 Percent Better Than Standard: 28.1 % BUILDING COMPLIES - NO HERS VERIFICATION REQUIRED enestration Building Front Orientation: (N) 0deg Ext. Walls/Roof Wall Area Area Dumber of Dwelling Units: 1.00 (N) 417 124 Fuel Available at Site: Natural Gas Os= 481 32 Raised Floor Area: 2, 391 (S) 453 113 Slab on Grade Area: 0 (W 263 18 Average Ceiling Height: 8.0 Roof 2,391 0 Fenestration Average U -Factor: 0.56 TOTAL: 287 Ave rag e SHG C: 0.65 Fenestration/CFA Ratio: 12.O % REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete, Documentation Author Company FRl Energy Consultants, LLC -6,1812013 Address 21 N. Harrison Ave Suile 210 Name Nicholas L Bignard! R08-11-2009 City/Stats2la Campbell, CA 95008 Phone 408-866-1620 S>ned Data The individual with overall design responsibility hereby certifies that the proposed building design represented in This set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater, Designer or Owner (per Business & Professions C ode) Company Steve Benzing, Architect Address 12405 Fredericksburg Name Stever Be "Ing a � k„ w, City/stateZp Saratoga, CA Phone 408-867-6910 Signed License # Date vier Pro 6,1 by Eneray$oftUser Number: 1315 RunCode: 2013-06-18T10:36:16 ID: 0130341 Page 6 of 13 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R project Name Eifaen Residence Building Type ® Single Family ❑ Addition Alone ❑ Multi Family m Existing+ Addition/Alteration Date 6/18/2013 OPAQUE SURFACE DERAILS Surface Type Area U- i Insulation Joint Appendix Factor' Cavity Exterior Frame I IntGriorl Frame Azm Tilt Status 4 Location/Comments Floor 1,730 0,097 None 0 180 Existing 4.4.1 -Al 1 st Floor Wall 60 0.358 Alone 0 90 Existing 4.3.1 -Al 1 st Floor Door 20 0.500 None 0 90 Removec 4.5. i -A4 1st Floor Wall 194 0.356 None 90 90 Existing 4.3.1-A1 1st Floor Wall 132 0.356 None 180 90 Existing 4.3.1-A1 1st Floor Roof 1,730 0.048 R-19 0 18 Existing 4,2.1-A16 1st Floor Wall 207 0.356 None 0 90 Removec 4.3.1-A1 1st Floor Wall 102 0.356 None 90 90 Removec 4.3.1-A1 1st Floor Door 18 0.500 None 90 90 Remove4 4.5.1-A4 1st Floor Wall 140 0.356 None 180 90 Removec 4.3.1-A 1 1 st Floor Well 78 0.356 None 270 90 Removec 4.3.1-A1 1st Floor Floor 661 0.037 R-19 0 180 1 New 4.4.1-A4 1st Floor Addition Wall 232 0.102 R-13 0 90 New 4,3,1-A3 1 st Floor Addition Wall 255 0.102 R-13 90 90 New 4.3.1-A3 1st Floor Addition Wall 208 0.102 R-13 180 90 New 4.3.1-A3 1st Floor Addition Wall 245 0.102 R-13 270 90 New 4.3.1-A3 1stF/oorAddition TENEETWA- TO -N SURFACE DETAILS ILLI Type Area U -Factor SHGC Azm Status Gla2lng Type Location/Comments 1 Window 32.0 0.580 Default 0.65 Default 0 New Double Non Metal Clear ist Floor 2 Window 8.0 0.580 Default 0.65 Default 90 Existing Double Non Metal Clear 1st Floor 3 Window 16.0 0.580 Default 0.65 Default 180 Existing Double Non Metal Clear 1 st Floor 4 Window 3.0 0.580 Default 0.65 Default 180 Removed Double Non Metal Clear 1 st Floor 5 Window 16.4 0.580 Default 0.65 Default 180 New I Double Non Metal Clear istFloor 6 Window 69.0 0.580 Default 0.65 Default 0 Removed Double Non Metal Clear 1 st Floor 7 Window 24.0 0.580 Default 0.65 Default 90 Removed Double Non Metal Clear 1st Floor 8 Window 53.4 0.530 Default 0.65 Default 180 Removed Double Non Meta! Clear Door 1st Floor 9 Window 47.0 0.580 Default 0.65 Default 180 Removed Double Non Metal Clear 1st Floor 10 Window 36.0 0.580 Default 0.65 Default 270 Removed Double Non Metal Clear 1 st Floor 11 Window 40.0 0.530 Default 0.65 Default 0 New Double Non Meta! Clear Door 1st Floor Addition 12 Window 36.0 0.580 Default 0.65 Default 0 New Double Non Metal Clear 1st Floor Addition 13 Window 16.4 0,580 Default 0.65 Default 0 New Double Non Metal Clear 1st Floor Addition 14 Window 24.0 0.580 Default 0.65 Default 90 New Double Non Metal Clear 1st Floor Addition 15 Window 60,0 0.530 Default 0.65 Desault 180 New Double Non Metal Clear Doan 1st Floor Addition 16 Window 21.0 0.580 Default 0.65 Default 180 New Double Non Metal Clear 1st FloorAdditlon (1) LI -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC T e: 118-8 = Default Table from Standards, NFRC - Labeled Value . E R OR SHADING DETAILS ID Exterior Shade Type SHGC Window H t Wd Ove hang Lett Fin Right Fin Len H t LExt RExt Dist Len Hot Dist Len H gt 1 Bug Screen 0,76 2 Bug Screen 0.76 3 Bug Semen 0.76 4 Bug Screen 0.76 5 Screen 0.76 -Byq 6 Bug Screen 0.76 7 By Screen 0.76 8 Bug Screen 0.76 9 Bug Screen 0,76 10 ByR Screen 0.76 11 Syg Screen 0,76 12 _Bug Screen 0.76 13 Buo Screen 0.76 14 Bug Screen 0.76 15 &g Screen 0.76 16 jBug Screen 0.76 Ener Pro 5,1 by Ener Soft User Number: 1315 RunCode; 2013-06-18T70;36;16 /D: 0130341 Pa e 7 of 13 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Projed Name •_nce Building Type :. Single Farnity ■ Multi Family ■ •.. A • Addition/Alterationr ., i OPAQUE SURFACE, DETAILS Joint Appendix 4 Location/Comments I st Floor Addition RE-NESTRATION =11120 M. LocationiComments Double Non Metal Clear Is t Floor Addition (1) U-Pactor Type: 11 6-A = Default Table from Standar&��Labeled Value P) SHGC Type: 116-8 - Default Table from Standards, NFRC Labeled Value E)MRIOR Exterior Shade Ty -. .�• r. i . I I - -.,::. CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5) CF -1 R Project Name Eitzen Residence Building Type [21 Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 6/16/2013 BUILDING ZONE INFORMATION System Name Floor Area ft Zone Name New Existing Altered Removed Volume Year Bullt HVAC System 1st Floor 1,730 13,840 1952 1 st Floor Addition 661 5,288 Totals 6611 01 1,730 0 HVAC SYSTEMS System Name Qty. Heatin Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC System 1 Central Furnace 8015 AFUE Split Alar Conditioner 13.0 SEER Setback Altered pre -altered for above Central Furnace 78% AFUE No Cooling 13.0 SEER Setback HVAC DISTRIBUTION System Name Duct Ducts Heating Cooling Duct Location R -Value Tested? Status HVAC System Ducted Ducted Attic, Ceiling Ins, vented 4.2 ❑ Altered pre -altered for above Ducted Ducted Attic, Ceiling Ins, vented 4.2 ❑ Ell WATER HEATING SYSTEMS S stem Name Qt . Type Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE Standby Loss or Pilot Ext. Tank Insul. R- Value Status A O Smith Water Products 1 Small Gas No Pipe Insulation 37,000 50 0.62 n/a n/a Altered Standard Gas 50 gat or Le 1 Small Gas pre -altered for Above 40,000 50 0.58 n/a n/a MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length ft o m — System Name Pipe Len th Pipe Diameter Insul. Thick. Ot . I HP Plenum Outside Buried 1 4000 EnergyFro 5.1 by Ener Soft User Number: 1315 RunCoda: 2013-06-18710:36:18 ID: 0130341 Page 9 of 13 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R roiect Nama Eifzen Residence Date 6/18/2013 Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -11R, CF -11R -ADD, or CF - 1 R -ALT Form) shall supersede the items marked with an asterisk (*) below. This Mandatory Measures Summary shall be incorporated into the permit documents, and the applicable features shall be considered by all parties as minimum component performance specifications whether they are shown elsewhere In the documents or in this summary. Submit all applicable sections of the MF -1R Form with plans. Building Envelope Measures: 1 16 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 Coeff Icient SHGC , and Infiltration that meets the requirements of § 10-111 (a). 117: Exterior doors and windows are weather-stripped; all oints and penetrations are caulked and sealed. 2118(a): Insulations ecifled or installed meets Standards for Insulating Material, Indicate type and include on CF -6R Form. 18(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 -1 R Form. 150(a): Minimum R-19 insulation in wood -frame ceiling orequivalent U -factor. 160(b): Loose fill insulation shall conform with manufacturer's Installed design labeled R -Value. 150 c : Minimum R-13 insulation in wood -frame wall ore uivalent LI -factor. *§150(d): Minimum R-13 Insulation In raised wood -frame floor or equivalent U -factor. 150(f): Air retarding wrap is tested labeled, and installed according to ASTM E1677-95(2000) when specified on the CF -1 R Form. 150 : Mandatory Vapor barrier Installed in Climate Zones 14 or 16. § 150(1): Water absorptlon rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance rate is no greater than 2,0 permlinch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas L Measures: 150 e tA: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square Inches in area and is equipped with a with a readily accessible operable, and fight -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 buildinci, are grohibited. Space Condftioniinq, Water Heating and Plumbing S stem Measures: $110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve backflow prevention, pump isolation valve, and recirculation loop connection requirements of § 113(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. 1 50 h : Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA. §1501(1): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §150(j)1A: 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. § 1500)1 B: 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. §1500)2: First 5 feet 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(1)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 1'50-B and Equation 150-A. 150Q 2: Pipe insulation for steam hydronic heating systems or hot water systems > 15 psi, rneets the requirements of Standards Table 123-A. §1506)3A: Insulation 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. 150(J)4: Solar water-heatingsystems and/or collectors are certified by the Solar Rating and Certification Corporation. Eater Pro S.1 by EnergySoft User Number: 1315 RunCoder 2013-06-18T10:36:18 /D: 0130341 Pae 10 of 13 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R roje d m'ne Date E taen Residence 1611812013 §150(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 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 1818 or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 114 inch the combination of mastic and either mesh or tape shall be used §150(m)l : 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. 1 50 m 7: Exhaust tans stems have back draft or automatic dampers. § 150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. § 150(m)g: 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 a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 150 m 10: Flexible ducts cannot have porous inner cores. §150(0): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quant 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. Pod! and Spa Heating Systems and Equipment Measures: §1 14(a): Any pool or spa heating 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 resistance heating or a pilot light. § 1 14(b)1. Any pool or spa heating equipment shall be installed with at least 36" of pipe between fitter and heater, or dedicated suction and return lines or built-up connections for future solar heating. I 14(b)2: Outdoor pools ors as that have a heat pump or gas heater shall 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-peak electric demand periods. 1 50 : Residential pool systems orequipment meet the pump sizinp, flow rate piping, filters and valve requirements of § 150 Residential Lighting Measures, §150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than 1he efficacies contained in Table 150-C and is not a low eff Icacy luminaire as specified by §150(k)2. &150(k)3: The wattacie 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: Lighling Lightingintegral to exhaust fans, in rooms other than kitchens shall meet the applicable requirements of §150(k). §160(k)7: All switching devices and controls shall meet the requirements of §150(k)7. §M(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting In kitchens shall be high efficacy. EXCEPTIOW Up to 50 watts for dwelling units less than or equal to 2,500112 or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50°7 high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (FMCS), 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 manual -on occupant sensor. 1 50(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. EnergyPro 5.1 by Energ Soft User Number: 1315 RunCode: 2013-06-18T10:36c16 1D: 0130341 Page 11 of 13 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R Project Narne Date Eitzen Residence 6/18/2013 §150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high efficacy. EXCEPTION 1: 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 occupancy 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 compiles 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 lumiunalre 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 hich 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 § 130(d). §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 sensors certified to comply with the applicable requirements of § 119. EnergyPro 5.1 by EnergySoft User Number: 1315 Run Code; 2013-06-i8T10,36;18 !D: 0130341 Page 12 of 13