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14040111Z CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10181 ADRIANA AVE CONTRACTOR: BAYONE PERMIT NO: 14040111 CONSTRUCTION INC OWN'ER'S NAME: XIAO ZHIHUA 194 ELBOSQUE DR DATE ISSUED: 08/19/2014 OWNER'S PHONE: 4083328331 SAN JOSE, CA 95134 PHONE NO: (408) 296-7888 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 0 License ClassLic. #_� Y CONSTRUCT ONE STORY ADDITIONS (1082 SQ FT); REMOVE Contractor AND REPLACE WATER HEATER AND FURNACE; __��Date_���—�(� UPGRADE ELECTRICAL PANEL (200 AMP). I hereby affix that I am licensed under the provisions of Chapter 9 REV # 1 - CHANGE ROOF FROM COMP TO TILE & ADD 1 (commencing with Section 7000) of Division 3 of the Business & Professions (N) WINDOW IN GUEST BEDROOM - ISSUED 12/1/14 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: $130000 performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this ANN Number: 32620023.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 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 WITHIN 180 DA IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter inspection 180 DAY„ ALLED INSPECTION. Upon the above mentioned property for purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, r costs, and expenses which may accrue against said City in consequence of the b Da e: Z JtY_ granting of this permit Additionally, the applicant understands and will comply I 4F with all non -point source regulations per the Cupertino Municipal Code, Section ./�" 9.18. �7 RE -ROOFS: Signature (jam Date�� All roofs shall be inspected prior to any roofing material being installed. If roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ,ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent; �� Dater permit is issued. 1 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10181 ADRIANA AVE CONTRACTOR: BAYONE PERMIT NO: 14040111 CONSTRUCTION INC OWNER'S NAME: XIAO ZHIHUA 194 ELBOSQUE DR DATE ISSUED: 08/19/2014 OWNER'S PHONE: 4083328331 SAN JOSE, CA 95134 PHONE NO: (408) 296-7888 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E]CONSTRUCT ONE STORY ADDITIONS (1082 SQ FT); License Class----L-.,Lic. 9 �}' f i- -3 REMOVE Contractor—j r r Date AND REPLACE WATER HEATER AND FURNACE; UPGRADE I hereby affirm that I am licensed under the provisions of Chapter 9 ELECTRICAL PANEL (200 AMP). (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: 1 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: $130000 performance of the work for which this permit is issued. 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: 32620023.00 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. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save _ 180 DAYS F4WKLXST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the > r granting of this permit, Additionally, the applicant understands and will comply Issued b� Date: y with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature_...._,.__..._,,, Date RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If 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 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. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued, will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized agent: Date: 1 � I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, i CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, l 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 comity 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 keepharmless 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--14-� d� CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDI t 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingQcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION t2ALTERATION / TI XREVISION /DEFERRED ORIGINAL PERMIT # 1( PROJECT ADDRESS c�f8 I D`Rtrg APN N 3Z�`�o--0�3 OWNER NAME \ PHONE E-MAIL �1 G STREET ADDRESS ^ (� ^ VZ� N CITY, STATE, ZIP rp� FAX CONTACT NAMES f v c V r PHpIvE� l C `14 1 Z� (¢ j E-MAIL l `� cf E� Ir Vi STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT RCHTCECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGIN'EER NAME, �w�c{ eVw LICENSE NUMBER C2137(2, BUS. LIC N COMPANY NAME E-MAILFAX STREET ADDRESS CITY, STATE, ZIPPHONE CQe)�f�6 -?q DESCRIPTION OF WORK '2 1 _ C ct J p (n 'C) i v1 'A a-cv (Zrue ft of VV 0 ILL - LEXISTING EXISTING USE PROPOSED USE CONSTR. TYPE N STORIES _v d K� USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH ❑ ATTACH i N DWELLING UNITS. IS A SECOND UNIT ❑YES SECOND STORY 0YES BEING ADDED! ❑NO ADDITION? ❑NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES AL VALUATION: PLAhNING APPLN WO PLANNING APPROVAL LETTER EICHLER HOME? W0 By my signature below, I certify to each of the following: I am the property er or au n the r s behalf, I have re d this application and the inform I have provided is correct. I have read the n of /e erify it Is ae. I agree to comply with all applicable local ordinances and state laws relate o uilding constructi authorize representatives of Cupemno to enter esti above -identified property for inspection purposes. Signature ofApplicant/Agei Date: (Z — - SUPPLEMENTAL INFORMATION RE RE Q PIAN C'H>~CK.T7i)'E R0TI7'INC SLIP 0, oVER-'THEC�TINTIt" ,. tIUDING rLANREVIEty= 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. ❑:-EKP ESS, ❑ PLANNING PLAN REVIEW, _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑, STANDARD PVBLICWoRTGS form if any Hazardous Materials are being used as part of this project. ❑ LARGE - ❑ TIRE&PT' _ Copy of Planning Approval Letter or Meeting with Planning prior to 0 MAJOR : -' ❑ $ANITA(2 SEWERDISTWCT submittal of Building Permit application. . © ENVIRONMENTAL HEAL'T'H RldgApp_2011.doc revised 06/21/11 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a cuper ino.org ❑ NEW CONSTRUCTION M ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS Io 181 ��p1��� E -7 ATN k OWNER NAME tarp . X I Ao PHONE b408) 332-g�3I E-MAIL STREET ADDRESSCITY, l b l 81 LAR If�IU� A STATE, ZIP FAX (4 - CONTACT NAME ^ b N PHONE (moog>g96�9ga E-MAILa ^ �j r N l� W'C1l CONI STREET ADDRESS a{ CITY, STATE, ZIP FAX 10 68 8flIU17 L Y ?�R. to CuLz�R I VC) (4a -s 996 -780 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CON7TACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENUMBER LICENSE TYPE BUS. LIC N COMPANY NAME E-MAIL FAX STREET ,,MDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK S TbQ I T-) o C -,t "F --3 (3 f 1 _ �1 D D c �(Q S� P ✓ 5 u r �( 'F cr t,., < <y 'j2 EXISTING USE PROPOSED USE -7 CONSTR TYPE F S70RIES S $:S t? _V-- f3 ( USE TYPE OCC. SQ.FT. VALUATION (S) FXISTG NEW FLOORDEMO AREA + AREA 2 TOTAL AREA /{� NET AREA �r {i3�g 1 , T 2 BATHROOM KITCHEN OTHER REMODEL AREA REh4ODEL AREA REN40DEL .AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH 41 � q' <�� k DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY YES ^, �— BEING ADDED? '§i -No ADDITION? '0 PRI. -APPLICATION []YES T YES, PROVIDE COPY of IS THE BLDG .AN [j YESCFIVFD B 3 ��" F TOTAL VALUATION: PLANNINGAPPLk 0 PLANNING APPROVAL LETTER EICHLER HOME? 0 i;g°"" per t By my signature below, I certify to each of the following: I am the property owner or authorized agent t e property owner's behalf. I have read this application and the information I ave 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 re ating to lding construction, I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: I Date: -4" �6 •— I SUPPLEMENTAL INFORMATION. REQI&ED ' a ,L, - slr� r. „,•_„ �: t(4�/^:��lZ"/i lj +'�}Y �fl,�y✓li 7//i`2Y �J ', " �, r���t YOfYI Q'4,�flr �ly"�t� { r % x f Q lvI/ ew SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building Qt EIt TIJF CGU1�`TPRn� BiJ7iDTI�GPLA REt'LEW tris permit for new building. ❑�2ass , 5 �' r� �I'd� �r piN�GpI RvJW f Ai ��r' � '� � N°Ceo�y��� 1�'� h�i, ✓���j� '��?b�����,'Fr���'�xl� in �,�fi'��`-�°J�f1.ifi ��'k ,.4 ����lr�,Y�"����r4�,9� �P �i'�5� � Commercial Bldgs: Provide a completed Hazardous Materials Disclosure�r form if Hazardous Materials are being used as of this ✓i, 1 i sir, 5 u r i;� pUPoRS i zed9„° r,d,�, i r 6'M ^i'NiM any part project. �l (y�✓� �' "��'tir�P� _ Copy of Planning Approval Letter or Meeting with Planning prior to M�ty' "��l'y�l�'pTf� 5rdt, hr ,trii f S��A n Rfj�b:17��5`T3/Yf'I ' ��d�� ,l��i4 ''"�I�TdfYISr1 r �. � submittal of Building Permit application. J111 AtPaR ti>> f' ;:�i1`1�p �^ xy�rra TT�aIr � ' �;f✓r?'�L�t,,..r�"ry �,(,.� .�,T,}�;rk/i �, j�" ;�"E 41RON''D4EHTAY:"fil✓ALTFY'�=,;_, u�;nr. Eld.oApp_2011.doc revised 06/21/11 CITY OF CUPERTINO Fm_­F,FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc. ). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053Bf.' 7/1.!13) ADDRESS: DATE: REVIEWED BY: Elec. Plan Check 1 0.0 1 hrs $0.00 APN: BP#: 'VALUATION: F0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex Other Elec. Insp. 0.0 hrs $48.00 PENTAMATION PRWHEATR USE: hrs PERMIT TYPE: WORK $0.00 SCOPE Mechanical 1 IMFR=<100 Furnace, Forced -Air NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc. ). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053Bf.' 7/1.!13) Mech. Plan Check El hrs $0.00 Plumb. Plan Check 0.0 hrs $0.00 Elec. Plan Check 1 0.0 1 hrs $0.00 Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: IEPERMIT Other Mech. Insp. I 0.0 hrs $48.00 Other Plumb Insp. 0.0hrs $48.00 Other Elec. Insp. 0.0 hrs $48.00 Suppl. PC Fee: Q Reg. Q OT 0.0 hrs NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc. ). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053Bf.' 7/1.!13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # $29.00 Plumbing IPRWHEATR I Water Heater Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 =# $143.00 Mechanical 1 IMFR=<100 Furnace, Forced -Air Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT Q,Q hrs $0.00 200 lamps Electrical $48.00 IBELEC200 Services PME Unit Fee: $0.00 PME Permit Fee: $144.00 Con,,;wuz ,::tion T(o-, T Administrative Fee: (ADMIN _145-M Q Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: $0.00 Select an Administrative Item BldE ,, Stds Commission Fee: $0.00 TJBTOTALS: , $237.00 $220.00'TOTAL FEE: '� $457.00 Revised: 07/07/2014 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10181 ADRIANA AVE DATE: 0411712014 REVIEWED BY: MELISSA APN: 326 20 023 BP#: 'VALUATION: $130,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? Yes No PENTAMATION 1 R3SFDADD USE: OTC. Yes ®No PERMIT TYPE: WORK ADD 1082 S.F. OF NLIVING SPACE TO CREATE 2 N MASTER SUITES AND_1 (N) FAMILY I SCOPE I ROOM 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-BjV,V-B 1,082 $2,597.03 IR3PLNCK $1,688.75 1R31NSP Suppl. Insp. Fee -.0 Reg. 0 OT FO.01hrs PME Unit Fee: $0.00 --71 -7E PME Permit Fee: $0.00 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: IPLLONGR $151.48 Select a Non -Residential Building or Structure Strong Motion Fee: IBSEISMICR TOTALS: 1,082 $2,597.03 $1,688.75 MECH, HOURLY 0 Yes G No PLUMB, HOURLY 0 Yes 0 No ` ELEC,14OURLY 0 Yes (E) No 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,688.75 Suppl. Insp. Fee -.0 Reg. 0 OT FO.01hrs PME Unit Fee: $0.00 --71 -7E PME Permit Fee: $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 Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff, 7%1,?3) Plan Check Fee: FEE QTY/FEE MISC ITEMS $2,597.03 Select a Misc Bldg/Structure or Element of a Building G Suppl. PC Fee: Q Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,688.75 Suppl. Insp. Fee -.0 Reg. 0 OT FO.01hrs PME Unit Fee: $0.00 $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: IPLLONGR $151.48 Select a Non -Residential Building or Structure Strong Motion Fee: IBSEISMICR $13.00 $6.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC SUBTOTALS: $4,456.26 $0.00 TOTAL FEE; $4,456.26 Revised: 04/01/2014 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10181 ADRIANA AVE DATE: 12/01/2014 REVIEWED BY: MELISSA APN: 326 20 023 BP#: 14040111 "VALUATION: Iso "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK REV # 1 - CHANGE ROOF FROM COMP TO TILE & ADD 1 N WINDOW IN GUEST BEDROOM - SCOPE ISSUED 12/1/14 u � u (VOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are hosed on the nreliminary information available and are onlv an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 L`L 71%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? C) Yes E No $0.00 1 hours $143.00 Plan Check, Hourly 1STPLNCK Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: Permit Fee: Hourly Only? Q Yes Q No $0.00 $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: PME Permit Fee: $0.00 $0.00 Work Without Permit? C) Yes Q No $0.00 $0.00 Advanced Planning Fee: Select a Non -Residential E) Building or Structure 0 t Strong Motion Fee: $0.00 1.0 hrs $143.00 Inspections iSTINSP Inspection, Hourly Bldg Std,, Commission Fee: $0.00 _ SUBTOTALS: $0.00 $286.00 TOTAL FEE: 1 $286.00 Revised: 10/01/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: I r7 / i ►' a, -710, U 'e- PERMIT # f O d f OWNER'S NAME:In tr ')4 PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: 2�r/— CITY/ZIPCODE: /f *Our municipal code requires all ss es�ses�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 Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Bate SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation i Fencing Flooring / Carpeting Linoleum 1 Wood Glass / Glazing° Heating Insulation Ef Landscaping Lathing Masonry Painting 1 Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Bate /qoo o �Z i CALGREEN RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL •- --_� F L CUPERTINO _ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ` i v „ (408) 777-3228 • FAX (408) 777-3333 - buitdingacupertino.org PURPOSE: . V The 2013 CalGreen Code applies to all newly constructed hotels, motels, lodging houses, dw Ili , dormitories, condominiums, shelters, congregate residences, employee housing, factory -built housing and other types of swellings with sleeping accommodations and new accessory buildings associated with such uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: '�/ I C) 0 —," f k.__t- I 0 f" I Project Address: t o ( I rl—) i:� ( rJ ) /4� 11—Z Project Description: % --�T b M,(.. t-) r�,Z� J'°" -( o Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with 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 shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Reauirements 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] U5 CalGreen_2014.doc revised 01/15/14 a A4.2 ENERGY EFFICIENCY 77 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. TER EFFICIENCY AND CONSERVATION 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following: ❑ 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank -type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank -type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, ❑ and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen_2014.doc revised 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. ❑ ❑ 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, 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. El 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 0 occupant or owner. 4.503.1 General. Install only a direct -vent sealed -combustion gas or sealed I El wood -burning fireplace, or a sealed woodstove. 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air 0 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. 0 El 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic 0 compounds. Page 3 of 5 CalGreen_2014.doc revised 01/15/14 4.504.2.4 Verification. Documentation shall be provided to verify that ❑ ❑ compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with ❑ ❑ VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHPS) Low -emitting ❑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. I�d�Q�r,�,IrQu����ty�nc� I�X�1dI,USt� 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the ❑ ❑ building 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. 0 702.1 Installer training. HVAC system installers are trained and certified in [a 1:1the 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 01115114 Project Name: Project Address: Project Description: CALGREEN SIGNATURE DECLARATIONS 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. Owners Signature Owner's Name (Please Print) X / 44-0 Design Professional's Signature' Design Professional's Name (Please Print) e Signature of License Profesresponsible for CalGreen compliance (:& /si n , /-W Name of Lice e rofessionaI responsible for CalGreen compliance (Please Print) Email P,,ddress for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION ,2 _ � Date Date Pho Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Name of License Professional responsible for CalGreen compliance (Please Print) Email Address for License Professional responsible for CalGreen compliance Date Page 5 of 5 CalGreen_2014.doc revised 01115114