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12080229CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10218 S TANTAU AVE I CONTR COR' PROVISION I PERMIT NO: 12080229 OWNER'S NAME: V1RAY PROPERTIES LLC 11288 KIFER RD STE 207 I DATE ISSUED: 10/24/2012 OWNER'S PHONE: 4089048614 I SUNNYVALE, CA 94086 1 PHONE NO: (408) 245-0991 1 LICENSED CONTRACTOR'S DECLARATION License Class_ �_ Lic. # f� �0��� Contractorf'6 vso Ft >� el cD flt late 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a'certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor'Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Si Date 1 24 o t. ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec,7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. BUILDING PERMIT INFO: BLDG F ELECT PLUMB MECH - RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: CONSTRUCTION OF A NEW TWO-STORY SINGLE FAMILY RESIDENCE 4,959 SQ FT AND ATTACHED GARAGE 452 SQ FT, TOTAL SQ FOOTAGE 5,411 SQ FT -SANITARY IS IN Sq. Ft Floor Area: I Valuation: $400000 APN Number: 37507032.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAY M LAST CALLED INSPECTION, Issy�d y: Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized ent: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Date I Licensed P CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10218 S TANTAU AVE CONTRACTOR: MLANDMARK PERMIT NO: 12080229 CONSTRUCTION INC OWNER'S NAME: ESMAIL ORANGIFAR 611 VETERNS BLVD DATE ISSUED: 10/24/2012 OWNER'S PHONE: 4089813983 REDWOOD CITY, CA 94062 PHONE NO: (650) 364-2721 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL License Class 15 Lic. # 6 ( ��' �� CONSTRUCTION OF A NEW TWO-STORY SINGLE Contractor fit{ q-( C?—��,+��' FAMILY RESIDENCE 4,959 SQ FT AND ATTACHED /�/. K-le�E t'1lt L ate GARAGE 452 SQ FT, TOTAL SQ FOOTAGE 5,411 SQ FT I hereby affirm that Iam licensed under the provisions of Chapter 9 REV # 1 - CHANGE ROOF SYSTEM CONVENTIONAL TO TRUSS (commencing with Section 7000) of Division 3 of the Business & Professions SYSTEM - ISSUED 9/10/2013 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: $400000 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: 37507032.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 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 ERMIT 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 T 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 Date. �t5 granting of this permit. Additionally, the applicant understands and will comply V: with all non -point source regulations per the Cupertino Municipal Code, Section 9.1. 8. t RE -ROOFS: g ate d — Signature All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Se c.7044, Business & Professions Code). 1 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 underlpenalty 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 1 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 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Set.ctions 25505, 25533 and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: J "` . Date:—[?_ - 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 1 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 1 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 R CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CLJPERTINA I (40 8) 777-3228 •FAX (408) 777-3333 • building cupertino.orq i�o (0;u CC NFWCONSTRIIC'TI()N F-1 AIN)rrl(1N F� AI.TFRATION/Tl F-1 RFv1SlC)N/r)FFFRRFr) C1RIC,FNAI PFRMITB PROJECTADDRESS 1 o 2 i p L5 Tanla� Ave V e a�ef APN # 1575-- 575- 07 r !1 3 2 O"INERNAME / P_ rj/5 I` VI rq 'Zv�- PHONE e- - 6 E-MAIL STREET ADDRESS 1©o ,,Oro C�• [= FAX CITY, STATE, ZIP 1'�J 1�CjaJ (.�J"` I5/(2 CONTACT NAME o,6 Na% aet Zkk, PHONE _ �©9 E-MAIL - akt L l�t(�a t, V STREET ADDRESS, �71r �M. , CITYSTATEZIP �LI FAX fig_�S Q �i ❑ OWNIER ❑ 01AWER-BUILDER ❑ OWNERAGENr ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME T-5 U LICENSE NUMBER LICENSE TYPE BUS. LIC x COMPANY NAME E-MAIL FAX STREET ADDRL-SS CITY, STATE, ZIP PHONE ARCHII-ECT/ENGINEER NAME J � I I LICE-ASENUMBER BUS. LIC N COMPANY NAME I Pfd E-MAIL FAX STREET ADD'RL•SS 6-10 J otw ren6e ,-yx , . :,'to 5 CITY, STATE, ZIP � �. P„r W /�, 1 /I�l Q PHONE DESCRIPTION OF WORK T biiJild a. new 2- S,n>r EXISTING USE PROPOSED USE CONS] R TYPE H S I DRIES J ( { i FXISR; � } NEW FLOOW,,'F ,, DEMO TOTAL AREA I(; AREA ' AREA 1 i ,Q- �°% NL 1' AREA !!! USE TYPE OCC SQ F ' VALUATION (S) BATHR MV REMODEL AREA KITCHEN REMODEL AREA RHMODEI.AREA PORCH DECK DECKK A�R}EA TOTAL DECK/PORCH AREA I GARAGE, AREA DETACH 45 jKArTACH P LAVFI LING IINrrS: IS A SECOND UNIT ❑YES SECOND STORY AYES BEINGADDED? 0 ADDITION? ❑NO PRI APPLICATION EYES IFYLS, PROVIDE COPY OF IS THE BLDG AN0 yES RECFIVEp PLANNING A] N NO PLANNING APPROv.AL - ER F LCHLER HOME? NO — — Y; VALUATION: TOTAL By my signature below, I certify to each of the following:L11 am the property owner or authorized agent to act on the property owners 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 stale laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicaDUAgent. _._ ._.__ . _ .---,.__.-_-- Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SIAP _ New SI=D or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. El r�FER rI»a EXPRESS atTnINGPhtYNREVIEW PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD ` � PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. LARGE � F°IRF. DEPr Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permitapplication_ MAJOR SANITARYSEIi'FItflAB'IYIICE ENVIRONMENTAL I-1.EALTH ldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION WADDRESS: 10218 S Tantau Ave DATE: 08/22/2012 REVIEWED BY: suew PC FEE 1D APN: 375-07-032 BP#: 12080229 "VALUATION: $400,000 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit. 0 Yes � No _.....-__. PENTAMATION 1 R3SFDW PERMIT TYPE: WORK SCOPE Permit Fee: OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE 1D BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 5,411 $3,151.85 1R3PLNCK $4,094.90 1R31NSP Permit Fee: $4,094.90 Suppl. Insp. Fee(j) Reg. 0 OT Q Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: Construction Tax: IBCONSr11XR 1 units $0.00 $595.41 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning -Fee: IPLLONGR $703.43 Select a Non -Residential Building or Structure 0 TOTALS: 5,411 $3,151.85 Select an Administrative Item $4,094.90 $16.00 NOTE: This estimate does not include fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). 'These fees are based on the orelininary information available and are only an estimate. Contact the Dent for addn'l into. FEE ITEMS (Fee Resolwion 11-053 Eff 71,1,-1 // FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,151.85 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT Q,Q hrs $0.00 PME Plan Check: $0.00 Permit Fee: $4,094.90 Suppl. Insp. Fee(j) Reg. 0 OT Q Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: Construction Tax: IBCONSr11XR 1 units $0.00 $595.41 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning -Fee: IPLLONGR $703.43 Select a Non -Residential Building or Structure 0 Strom,- Motion Fee: IBSEISMICR $40.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $16.00 SUBTOTALS: 1 $8,601.59 $0.00 TOTAL FEE: $$ 601.59 Revised: 07101/2012 CITY OF CUPERTINO Fm --7 FEE ESTIMATOR - BUILDING DIVISION FA OCCUPANCY TYPE: 10218 S Tantau Ave DATE: 08/21/2012 REVIEWED BY: ImADDRESS: APN: 375-07-032 BP#: *VALUATION: 1$4000,00 PERMIT TYPE:Building Permit PLAN CHECK TYPE: New Const ction PRIMARY SFD or Duplex USE: • 2nd Unit? Yes No PENTAMATIO I R3SFD PERMIT TYP WORK Permit Fee: SCOPE Suppl. Insp. Fee:Q Reg. ® OT FA OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.L PC FEES PC FEE BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B ✓� 1 /� $3,814 IR3P NCK $ 1R3INSP Permit Fee: $3,924.92 Suppl. Insp. Fee:Q Reg. ® OT 0.0 hrs $0.00 r PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # newunits $595.41 a/A' r`,, Work Without Permit? 0 Ye Q No $0.00 Advanced Planning Fee: / IPLLONCR TOTALS:5,101 Select a Non -Residential 0 Building or Structure $3,1 .28 $3,924.92 $40.00 f'lrrrrw NUN ("lxs F'///Mb F'ev,r+r1 L, 11'11"! P/ 'rr lre;lo 0,Put' r %'t"j," i Ii rdr iv,I, h':�c° t'lrnn,,h, r,r 1,. ,��e':.! r u. lFts/, !•��e� NOTE: This estimate does not include fees due to other Departure is (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nictrirt otr.) Thorn feac are hnced an the nreliminary intarmatiA availahle and are onlv an estimate Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 711111) F QTY/FEE MISC ITEMS Plan Check Fee: $3/30.28 Select a Misc Bldg/Structure or Element of a Building • Re OT Suppl. PC Fee: g. 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,924.92 Suppl. Insp. Fee:Q Reg. ® OT 0.0 hrs $0.00 r PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # newunits $595.41 a/A' r`,, Work Without Permit? 0 Ye Q No $0.00 Advanced Planning Fee: / IPLLONCR $663.13 Select a Non -Residential 0 Building or Structure lT J` r;.7 Om V(_ Strong Motion Fee: IBSEISMICR $40.00 Select an Administrative Item Bldg Stds Commission Fee: f IBCBSC $16.00 SUBT6*" $0.00 TOTAL FEE: (reeoll �_v Revised: 07/01/2012 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ( 4 77 08) 7-32 0 28 •FAX (408) 777-3333 • building ancupetno.org }� ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT N 2 v Q Z2� PROJECT ADDRESS APN # OWNER NAME PH E-MAIL STREET ADDRESS ITY, STATE, ZIP FAX CONTACT NAME "�. � A �1 0 ti P 5— P MAII ; }N p ' �, CK STREET ADDRESS 1 CITY, STATE ZIP FyX (12 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME . LICENSE NUMBER LICENSETYPE BUS. LIC # l.. COMPANY NAME rd ° E-MAIL STREET ADDRESS CITY, STATE, ZI P ARCHrrECT/ENGINEER NAME LICENSE NUMB ER BUS. LIC # COMPANY NAME _ E-MAIL FAX STREET ADDRESS __._ CITY, STATE, ZIP PHONE DESCRIPTkN OF WO .®7 aj EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER , REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH ARE GARAGE AREA: LJDETACH ATTACH I # DWELLING UNITS: 1S A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF 1S THE BLDG AN ❑ YES^� r r �GII/ y<<r` TOTAL VALUATION; PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agentoperty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con frac ion. authorize representatives of Cupertino to enter the above -identified property for inspection purposes. , -- N Signature of Applicant/Agent: Date: SUPPLEMENTAL rNTFOR MATION REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building rQov>.~ttar�xsa�T><x"y;rrr � � fDlSJI,DIAGr�Arrft>+av�i,�,,��;xa permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure o used as part ofthis project form if any Hazardous Materials are beim �L�G�r����� � y �� rr r,�� I�rl,1,�, �✓ � f���1��� � �,a,r,i;i�yy,,,� ,r�r� n�i��� ,� ,, � aiy' �' �,� y�� �, �,�� Copy of Planning Approval Letter or Meeting with Planning prior to 1�i������%��,;��;lt��i�t✓y��r, i �����c�, ��F��,��j�J _ submittal of Building Permit application. i11 AJDR (ief r t� �ayli �'�� i� �� ���i Q'/ SANITARY Sk�4R DISTRrCTj �I�a� H'c B1dgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO MAN FEE ESTIMATOR - BUILDING DIVISION � ,i/„ii,i i,,/ i/ ADDRESS: 10218 S TANTAU AVE DATE: 07/23/2013 REVIEWED BY: MELISSA Plan Check Fee: Hourly Only? 0 Yes 1E) No APN: IBP#: l,IPf c }�nwr F, e'- *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex PME Plan Check: PENTAMATION PERMIT TYPE: 1 GENRES WORK REV # 1 - CHANGE ROOF SYSTEM CONVENTIONAL TO TRUSS SYSTEM SCOPE Suppl. Insp. Fee:O Reg. Q OT � ,i/„ii,i i,,/ i/ FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 1E) No $0.00 l,IPf c }�nwr F, e'- Suppl. PC Fee: (F) Reg. Q OT 0.0 1 0//r(r /' ICS Imp Ll $0.00 PME Plan Check: J,Ic(. lrs,�, ("'(- Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 roc" 0 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Q Building or Structure 0 A 7'rove d i)oemrrc'nlation Fces : iZ � ,i/„ii,i i,,/ i/ FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 1E) No $0.00 l,IPf c }�nwr F, e'- Suppl. PC Fee: (F) Reg. Q OT 0.0 1 0//r(r /' ICS Imp Ll $0.00 PME Plan Check: J,Ic(. lrs,�, ("'(- NOTE. This estimate does not include fees due to other Departments ft e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etch These fees are based on the nreliminary information available and are on/v an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 1E) No $0.00 2 hours Plan Check, Hourly $278.00 1sTPLNCK Suppl. PC Fee: (F) Reg. Q OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 roc" 0 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Q Building or Structure 0 A 7'rove d i)oemrrc'nlation Fces : Strong Motion Fee: $0.00 Select an Administrative Item Bldg_Stds Commission Fee: $0.00 ✓��� ,,, ,�, „ ,,, ,�„/ , , $0.00 $278 00 %,��,�,;,�„ ��, ,, / �, ��p�a ;- $278.00 Revised: 07/01/2013 2010 CAL GREEN RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION C(JPE TINO ALBERT SALVADOR P E C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 0 3 8 0- UBMITTAL (6400)'777-3333 • building a()cupertino.org #2 PU RP The 2010'CdlGreeh Code applies to all newly constructed hotels, motels, lodging houses, dwellings, 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. Vi FIAX Project Address: __JpZ R S T kIlAd AVP Project Description: 7`0 BUtL-D A NCW TV40 - S TV K/IgC51DF_NGE. Instructions: 1. The Owner or the Owner's agent shall emploZt� professional e r ith the 2010 California Green Building Standards Codes to verify an t all required rein is properly planned and implemented in the project. Building Department 2. The licensed professional, in collaboration wir and the design professional shall initial Column 2 r>7 r1 �i checklist, sign and date Section 7fir _10`nJ,aytq01 d of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Departm9ft, MFcQrR@R ��rrlplete Column 3 and sign and date Section 2 Implementatiajo(�,tction at the his chec Ist and submit the completed form to the Building Inspector. "'°"""" Page I of 5 CMG cen_2010.doc revised 08/27111 P<e 2 of 5 CulGi cn 2010.doc recised08/27,71 General" 4.201.1 Low-rise residential buildings shall meet or exceed the minimum ❑ standard design required by the California Energy Standards. 91 Indoor Water Use 4.303.1 Indoor water use shall be reduced by at least 20 percent using one of the follow methods. 0 ❑ Water saving fixtures or flow restrictors shall be used per Table 4.303.2.] ElA As of 710112011 20 percent reduction in baseline water use shall be demonstrated per Table 4.303.1. 4.303.2 When using the calculation method specified in Section 4.303.1, multiple showerheads shall not exceed maximum flow rates. As of 7/0112011 4.303.3 Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with specified performance requirements. As of 710112011 Outdoor Water Use 4.304.1 Automatic irrigation systems installed at the time of final inspection lel shall be weather -based. n Enhanced Durability and Reduced Maintenance 4.406.1 Joints and openings. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected L�1 against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. Construction Waste Reduction, Disposal and Recycling 4.408.2 Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall X❑ be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 An operation and maintenance manual shall be provided to the F I-7 L! building occupant or owner. P<e 2 of 5 CulGi cn 2010.doc recised08/27,71 Pane°. 3 of 5 CaiGreen ?010.doc revised 08127/11 ilrC'plaGeS 4.503.1 Install only a direct -vent sealed -combustion gas or sealed wood- X ❑ burning fireplace, or a sealed woodstove. Pollutant Control 4.504.1 Duct openings and other related air distribution component openings u shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks shall be compliant with VOC and iJ ❑ other toxic compound limits. 4.504.2.2 Paints, stains and other coatings shall be compliant with VOC limits. 0 ❑ 4.504.2.3 Aerosol paints and other coatings shall be compliant with product ❑ weighted MIR Limits for ROC and other toxic compounds. 4.504.2.4 Documentation shall be provided to verify that compliant VOC limit r� L^] ❑ finish materials have been used. 4.504.3 Carpet and carpet systems shall be compliant with VOC limits. ❑X ❑ 4.504.4 Fifty (50) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance ❑ ❑ Schools (CHPS) Low -emitting Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall comply with low formaldehydeElemission standards. Interior oisture Control 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. 0 ❑ 4.505.3 Moisture content of building materials used in wall and floor framing is F71 LJ ❑ checked before enclosure. Pane°. 3 of 5 CaiGreen ?010.doc revised 08127/11 Indoor ,kir-Quality and Exhaust 4.506.1 Exhaust fans which terminate outside the building are provided in n L^J every bathroom. Environmental Comfort 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the fan is off. Covers or louvers shall have a minimum F7X insulation value of R-4.2. 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. Qualificat ons 702.1 HVAC system installers are trained and certified in the proper installation F7 l^1 of HVAC systems. 702.2 The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect E and verify. Verifications 703.1 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. Pag),e 4 � if 5 CulGreen_2010.doc revisedO812711 l CAL -GRA= EN iDNA T U E DEQ' L.A RATIONS Project Flame: VIZ i=2E5l PEXILE --......__...-- Project Address: j„U2Lg _ w T%}I ,AU Aye. Project Description: J Q 6 1J(LD Uf SECTION 1 — DESIGN VERIFICATION Complete all Eines 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 profes Tonal responsible for compliance with CalGreen Standards have revised the plans and certify that the items checkte bove are hereby incorporated into the project plans and will be implemented into the project in accordance withquirements set forth in the 2010 California Green Building Standards Cade as adopted by the Cty of Cu. Owner's Signature Owner's Name (P Date 6M7n-Professional's Signature Date Design Professio>r 4' e Print) 02/20!2 License Professional responsible for CalGreen compliance Date JOHN _.. _ --- , ----_ Name of License Professional responsible for CalGreen compliance (Please Print) Phone _1 1- /- - /1, • / _ n t1 _ Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERiFICA,rmi 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 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Ernail Address for License Professional responsible for CalGreen compliance Page 5 of 5 CulGreew 2010.doc revised 08/27/11