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12030154CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 866 LILY AVE I CONTRACTOR: TUAN PHAN I PERMIT NO: 12030154 OWNER'S NAME: TUAN PHAN 1866 LILY AVE I DATE ISSUED: 06/01/2012 OWNER'S PHONE: 4083068552 1 CUPERTINO CA, CA 950144211 I PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the 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. Signature Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner 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 construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature T Date I /a– BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: ADD 774 SQ FT TO LIVING/M.SUITE BATHROOM, 60 SQ FT TO COVERED PORCH, REMODEL 28 SQ FT TO BATHROOM Sq. Ft Floor Area: I Valuation: $140000 APN Number: 35903036.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: J�rlI✓ /-1,4%G�l Date: 6 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Date: L9—/ -.x-- 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION € ERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINQ (408) 777-3228 - FAX (408) TT7-3333 building(a�cupertino.om .tet-, n NEW CONSTRUCTION IN ADDT.TION V AL=A-l`lON / TI I� u FvrernT I i nz a Fn ia03o�s nv MMIS A T ULD %AT'r A PROTECT ADDRESS (%1 r, ' l LICENSE TYPE AFN # OWNER NAME E-MAIL PHONE ,,�A � (apj� Eh{AII p o 1`+ SIStEET AD 1 (_ / �, srarE� e FAx CONTACT NAME COMPANY NA�� r U 6 � t u Imo' �"�`a_ E �� Pfl0 STREET ADDRESS STREETADDRESS PHONE CITY, STATE, ZIP FAX TOTAL NET AREAeRy/ ` ,/' �q I❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACiORAGENT ❑ ARCRITECr ❑ ENGINEER ❑ DEVELOPER ❑ ,,Axr CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE Bus. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAME v l• LICENSE NUMBER e'•� 9 �b L -a BUS. LIC # COMPANY NA�� r U 6 � t u Imo' �"�`a_ E �� FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK r � L` L3 or IJ % % S`► �--� 1 �� L! ', I I ry Cr r2 r, ivl c Tc iZ ir.,1-r—, ; —F R/'.a7 h 4 � 1 =738, USE PROPOSED USE CONSTR. TYPE # STORIES STANDARD 715�❑ PUBI IC WORIS.S� ❑ LARGE ❑ Fm DEPT ❑ MAJOR SANITARY SEWER DISTRICT /❑�" s / V USE TYPE OCG SQFT. VALUATION (S) E=TG /-� AREA /✓ NEW FLOOR AREA 7< � DEMO AREA .. TOTAL NET AREAeRy/ ` ,/' s1 77'1 f �]T . BATHROOM REMODELAREV,7 -5 KITCHEN REMODEL AREA OTHER REMODEL AREA ,L", C � / V PORCH AREA DECK AREA TOTAL DEMPORCH AREA GARAGE AREA. DETACH �vos -49-g- -/97 TTACH V6 23 0 -2 # DWELLING UNIT'S: ISA SECOND UNIT EIYES SECOND STORY L]YES f BEING ADDED? XNO ADDITION! UNO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECHrVED BY: TOTAL VALUATION: PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? NO ! VA C)C�0 riy my signatt= below, I certify to each of the following I am the property owner or authorized agent to act on the prpperty.owner's hehaTf. I have read this application and the infotmation 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 hn;id;nv,�ction. I tho ' representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant(Agmt L Date: > CJ 2r - SUPPLEIVILTITAL INFORMATION RtQ=D per{ CHECK TYPE ROUTING SLIP 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 budding. —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. ❑ OVER-T'HE-COIINTER � BiTII.DING FLAN REYILR' ❑ EXPRESS PLANNTG PLAN REVIEW STANDARD 715�❑ PUBI IC WORIS.S� ❑ LARGE ❑ Fm DEPT ❑ MAJOR SANITARY SEWER DISTRICT /❑�" ENVIRONMENTAL HEALTH BldgAp.p 2011.doc revised 06/21/11 Q L—CVt I-- -C�tK CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 866 LILY AVE CONTRACTOR: TUAN PHAN PERMIT NO: 12030154 OWNER'S NAME: TUAN PHAN 866 LILY AVE DATE ISSUED: 06/01/2012 OWNER'S PHONE: 4083068552 CUPERTINO CA, CA 95014-4211 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic. # _ REV#1 - DELAYED SUBMITTAL-ROOF TRUSSES Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $140000 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 APN Number: 35903036.00 Occupancy 'Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 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, costs, and expenses which may accrue against said City in consequence of the ��jj / �f granting of this permit. Additionally, the applicant understands and will comply Issued b /��/f /7/4 %G� Date: y:., 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 I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm tinder penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino 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 n Owner or authorized agent' Date: l 1 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, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 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. - a Signature V Date ( ��— L CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTIN (408) 777-3228 •FAX (408) 777-3333 • building a-) [:]NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS AU e_ APN # 0 •3 _ O 't- f OWNER NAMETo PHONE �j�p r!�/: • pZ E-MAIL STREET ADDRESS + CITY, STATE, ZIP ^ Ya � /� FAX KS /A- � CONTACT NAME O CONTACT PHONE I ry�M3 � g � Z / E-MAIL � ���G�✓l �p Y�RM STREET ADDRESS r7 _ CITY, STATE, ZIP g � FAX W A OR 1:1 OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT El ARCHITECT WNE El ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME ks* V t! BUS. LIC # COMPANY NAME FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK w\ n t • ck bE; Y �� Q, EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES ID w f- -L-1 A/ (1 6,4 omit- _ %3 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA (l - BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: EIDETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES -:RECEIVED. BY: TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? E] NO 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 building construction. I a tho 'ze representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: % Date: �— IID SUPPLEMENTAL INFORMATION QUIREDPLAN CHECK TYPE' ROUTING SLIP, ❑ ❑ BUILDING _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building , OVER-THE-COUNTER PLAN REVIEW permit for new building. ❑ . EXPRESS, ❑ PLANTING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ _STANDARD E T PUB66WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE, FIRE DEPT _ Copy Of Planning Approval Letter Or Meeting with Planning prior t0 El ❑ submittal of Building Permit application. MAJOR SANITARY SEWER DISTRICT El ENVIRONMENTAL HEALTH - B1dgApp_2011.doe revised 06/21/11 �� CITY OF CUPERTINO 1'' N FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 866 Lily Ave DATE: 09/10/2012 REVIEWED BY: RDW PC FEE ID APN: 359-03-036 BP#: 12030154 'VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? 0 Yes No I OTC. ® Yes No PENTAMATION 1DSR3 PERMIT TYPE: WORK Dela ed submittal - Roof Trusses SCOPE Suppl. Insp. Fee -0 Reg. ® OT OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (s.f. PC FEES PC FEE ID BP FEES BP FEE ID Deferred Submittal (R-3) II-B,III-B,IV,V-B 0 $0.00 Ther Elec. Insp. $0.00 l'/uu,h_ ?,,.q). Fez: (ec. Iris/,. Fee. $0.00 Suppl. Insp. Fee -0 Reg. ® OT 0,0 hrs $0.00' PME Unit Fee: $0.00 PME Permit Fee: $0.00 I Constr-iietion Tax: Administrative Fee: O 0 Work Without Permit? O Yes 0 No $0.00 TOTALS: 0 $0.00 Travel Documentation Nees: $0.00 Strong Motion Fee: MECH, HOURLY © Yes E) No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No Me& Pi: Plumb. Plan Check Elec. Plan Check Select a Misc Bldg/Structure or Element of a Building Plumb. Permit Fere: Elec. Permit Fee: lrirc , 4"'), in.•p Other Plumb Insp. Li Ther Elec. Insp. Wch. Insp. Fee: l'/uu,h_ ?,,.q). Fez: (ec. Iris/,. Fee. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Sewer District, Ncfoot nictrirG etc )_ Thece feec are ha.ced an the nreliminary information available and are onlv an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E{f. 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OTF2.0 hrs $260.00 PME Plan Check: ISUPPKFEE $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. ® OT 0,0 hrs $0.00' PME Unit Fee: $0.00 PME Permit Fee: $0.00 I Constr-iietion Tax: Administrative Fee: O 0 Work Without Permit? O Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential G Building or Structure � I i Travel Documentation Nees: Strong Motion Fee: $0.00 Select an Administrative Item ' Bldg- Stds Commission Fee: $0.00 SUBTOTALS: $260.00 $0.00 TOTAL FEE: $ 00 Revised: 07/01 /2012 CITY OF CUPERTINO F -M-17 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 866 Lily Ave DATE: 03/30/2012 REVIEWED BY: Sean C FEE ID APN:35`' J _03 BP#: 01S *VALUATION: $140,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: 2nd Unit? Yes • No OTC? 0 Yes E)No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK Construct 774 sq ft new living room/master bedroom and bathroom remodel closet into 1/2 bath 27.5 SCOPE sq ft), construct 60 sq ft covered porch. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC C FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 834 $2,420.0 1R3PLNCK $1,519.00 1R3INSP //Elee.Insp. f.t'C'!'. IF75'o t`"c' $0.00 Permit Fee: $1,519.00 Suppl. Insp. Fee -0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 834 $2,420.00 $1,519.00 MECH, HOURLY 0 Yes G No PLUMB, HOURLY C) Yes Q No ELEC, HOURLY ® Yes Q No cch. Plan C'hcr T-FPhimb. Plan Check 1aec. Plan Check FMec,h. Perrnit Fee:Plumb. Permit Fere: F.1ec. Permit Fee. Ot,'wr A ech.lnls , Other Plumb Invp Other Li .t�,�i !-o f`• i'. Fri 7f €triJ I7?e'I' i //Elee.Insp. f.t'C'!'. IF75'o t`"c' 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 prelimina information available and are oniv an estimate. Contact the De t or addn'l in o. FEE ITEMS (Fee Resolution 11-053 E . 7i1,i11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,420.00 28 s.f. $588.00 Remodel, Bath (<=300 sf) IREMRESBAT Suppl. PC Fee: (F) Reg. OT 0.0 1 firs $0.00 PME Plan Check: $0.00 Permit Fee: $1,519.00 Suppl. Insp. Fee -0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construezion 1 ax. Adininistrative.I ee: O E) Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: PLLONGRNGR $108.42 Select a Non -Residential Building or Structure 0 � 71�<n�crll)octnrtc�tttrtrorr 1,e�c.: Strong Motion Fee: IBSEISMICR $14.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $6.00 SUBTOTALS: $4,067.42 $588.00 TOTAL FEE: F$4,655.42 Revised: 1/19/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR /SUBCONTRACTOR LIST JOB ADDRESS: E56 V - !U - PERMIT # /Cw- SO /S OWNER'S NAME: --d PHONE # 4og - 3v 6 . 9S� Z GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: c ti, V4 ACVG _ CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Contractor Signature Date Building Department City Chi'(-`Upertino 10300 Torre AvenUe Cupertino. CA 95014-3255 Telephone: 408-777-3-22ti Fax: 408-777-3.33.1, 0111117111,z 1"CONTRACTOIR, LIS -l" JOB ADDRESS: 866 LILY AVE., CUPERTINO PERMIT, 12030154OWNER'S I AME.TUAN (TONY) PHAN �� 1?II( Tti ( 408 306.8552 GFNERAS CONTRACTOR: OWNER BUSINESS C tt F;NSF r: N/A AI)I1RESS:888 LILY AVE., CUPERTINO, CA 9 O 4 I d I-Y!ZIPC-ODE:95014 *Our municipal code requires all businesses wo kiaig in tilt vity to have a Cite of Cupertino business license. NO I3C IVDING FINAL OR FINAL OCCUPANCY ' INSPE(--l-ION(S) WILL BE SCIIEDUL1?1) UM -11; '1111 GENERAL CONTRACTOR R Alin AI l C"O NTRAC:TORS HAVE OBTAINED ACITY' OF CUPEP"r!NO BUSINESS ... R�... _.... March 19, 2013 I3 I am not using auy subcontractors. ° inattare [iiatC Please check applicable subcontractors and ccsmi)lete the following information: -- SURCO3N"TRACTOR BUSINESS NAME i BUSINESS LICENSF.;! Cabinets &Millwork � Cement Finish -ng ------ Electrical Excavation �l's;1lClns� i , i Floomilo / Carpeting Linoleum / Wood Glass / Glazing Heating l—is lilat' ion I Lanjgdscapin Lath Ing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal_._ Sheet Rock `Idle CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building(a)cuoertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SIT"gR"�y A \r6' ����I�t� APN BP# OWNER NAME—� v :P OWNER A S DESCRIPTION OF WORK: We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) "I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Ider" building permit that erroneously implies that the property owner is providing his or her own labor and material r personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. . I understand building permits are not required to be signed by property owners unless they are responsible for t e construction and are not hiring a licensed Contractor to assume this responsibility. 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may p tect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license tubers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the taI value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. 6. I understand if I am considered an "employer' under state and federal law, I must register with the state and eral government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family sidential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for y financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. avnerBuilderForm 2010.doc revised 04/14/10 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal venue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. --ID- 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I W the party legally and financially responsible for proposed construction activity at the site address listed above. '-- 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide all applicable laws and requirements that govern Owner -Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the orr ion I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address:^`VA- Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's si nature. Property Owner's Signature: Date: A_ -= 1f Z - -------------------------------------------------------------------------------- ----------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 014'17e1'BLlilde!"Foi-i?2 2010.doc revised 04114/10 BUILDING ENERGY ANALYSIS REPORT PROJECT: PHAN'S RESIDENCE 866 LILY AVENUE CUPERTINO, CA 95014 Project Designer: JTZ BU) CUPERMI4@10 61 ARCHITECTS INC Building l epart""1480 SARATOGA AVE SARATOGA, CA 95070 MAY 3 t 2"' 408.892.5020 REVIEWED FO MPLIANCE Reviewed By: OFFICE COP Report Prepared by: FRANK L. HO STUDIO 61 ARCHITECTS INC 12480 SARATOGA AVE SARATOGA, CA 95070 408.892.5020 Job Number: 1142 Date: 5/10/2012 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 Nonresidential 2008 Building Energy Efficiency Standards. IThis program developed by EnergySoft, LLC — www,energysoft.com. I EnergyPro 5.1 by EnergySoft User Number. 5750 Run Code: 2012-05-10T10:52:36 ID 1142 I TABLE OF CONTENTS I Cover Page Table of Contents Form CF -1 R Certificate of Compliance Form MF -1 R Mandatory Measures Summary HVAC System Heating and Cooling Loads Summary Room Load Summary Room Heating Peak Loads Room Cooling Peak Loads Form ECON-1 Energy Use and Cost Summary Form ECON-2 Energy Upgrade Recommendations Form UTIL-1 R Utility Incentive Worksheet EnergyPro 5 1 by EnergySoft Job Number: ID: 1142 _ User Number. 5750 1 2 3 8 11 12 13 14 15 16 17 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF -1 R Project Name PHAN'S RESIDENCE Building Type m Single Family ❑ Addition Alone ❑ Multi Family m Existing+ Addition/Alteration Date 5/10/2012 Project Address 866 LILYAVENUE CUPERTINO California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 2,291 Addition 0 # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes IZI No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form. ❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavity (ftp) Features (see Part 2 of 5) Status Floor Wood Framed w/Crawl Space R-19 2,291 New Wall Wood Framed R-13 1,568 New Door Opaque Door None 42 New Roof Wood Framed Attic R-30 2,283 Radiant Barrier Venting New FENESTRATION U- Exterior Orientation Area(e) Factor SHGC Overhang Sidefins Shades Status Front (W) 86.3 0.390 0.37 none none Bug Screen New Right (S) 133.5 0.390 0.37 none none Bug Screen New Rear (E) 74.0 0.390 0.37 none none Bug Screen New Left (N) 50.5 0.390 0.37 none none Bug Screen New Skylight 8.0 0.550 0.55 none none None New HVAC SYSTEMS Ot . Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 80% AFUE Packaged Air Condition 14.0 SEER Setback Existing HVAC DISTRIBUTION Duct Location Heating Cooling Duct Location R -Value Status HVAC System Ducted Ducted Crawlspace 8.0 New WATER HEATING Qty. Type Gallons Min. Eff Distribution Status EnergyPro 5.1 by Ener Soft User Number: 5750 RunCode: 2012-05-10T10:52:36 ID. 1142 Page 3 of 17 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF -1 R Project Name PHAN'S RESIDENCE Building Type m Single Family ❑ Addition Alone ❑ Multi Family m Existing+ Addition/Alteration Date 5/10/2012 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification 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. The Roof R-30 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential Appendix RA4.2.2. The Roof R-30 Roof Attic includes an Airgap below Roofing 1/150 Vent Area 50% of Vents Located High requires verification. 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 -4R form for each of the measures listed below for final to be given. EnerqvPro 5.1 by EnerqySoft User Number. 5750 RunCode: 2012-05-10T10:52:36 ID: 1142 Page 4 of 17 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1 R Project Name Building Type m Single Family ❑ Addition Alone Date PHAN'S RESIDENCE ❑ Multi Family [Z Existing+ Addition/Alteration 5/10/2012 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2- r Space Heating 20.04 18.13 1.91 Space Cooling 6.29 4.97 1.31 Fans 4.52 3.96 0.56 Domestic Hot Water 15.56 15.56 0.00 Pumps 0.00 0.00 0.00 Totals 46.41 42.62 3.78 Percent Better Than Standard: 8.2% BUILDING COMPLIES - NO HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (04 270 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (W 372 86 Fuel Available at Site: Natural Gas (N) 620 51 Raised Floor Area: 2,291 (E) 426 74 Slab on Grade Area: 0 (S) 537 134 Average Ceiling Height: 8.7 Roof 2,291 8 Fenestration Average U-Factor: 0.39 TOTAL: 352 Average SHGC: 0.37 Fenestration/CFA Ratio: 15.4% 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 STUDIO 61 ARCHITECTS INC 5/10/2012 Address 12480 SARATOGA AVE Name FRANK L. HO 0�9 City/State/ZipCity/State/Zip SARATOGA, CA 95070 Phone 408.892.5020 Signed Date 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 Code) Company STUDIO 61 ARCHITECTS INC Address 12480 SARATOGA AVE Name FRANK L HO City/State/Zip SARATOGA, CA 95070 Phone 408.892.5020 Signed License # Date EnerqyPro 5.1 by EnergrySoft User Number: 5750 RunCode: 2012-05-10T10:52:36 ID. 1142 Pa e 5 of 17 ERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project Name PHAN'S RESIDENCE Building Type m Single Family 13Addition Alone [3Multi Family 2 Existing+ Addition/Alteration Date 1511012012 OPAQUE SURFACE DETAILS Surface U- Insulation Joint Appendix Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Floor 2,291 0.037 R-19 01 180 New 4.4.1-A4 Zone 1 Wall 244 0.102 R-13 270 90 New 4.3.1-A3 Zone 1 Door 42 0.500 None 270 90 New 4.5.1-A4 Zone 1 Wall 403 0.102 R-13 180 90 New 4.3.1-A3 Zone 1 Wall 352 0.102 R-13 90 90 New 4.3.1-A3 Zone 1 Wall 569 0.102 R-13 0 90 New 4.3.1-A3 Zone 1 Roof 2,283 0.031 R-30 90 18 New 4.2.1-A20 Zone 1 FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHGC Azm Status Glazing Type Location/Comments 1 Window 86.3 0.390 NFRC 0.37 NFRC 270 New Milgard Classic Low -E Vinyl Zone 1 2 Window 133.5 0.390 NFRC 0.37 NFRC 180 New Milgard Classic Low -E Vinyl Zone 1 3 Window 74.0 0.390 NFRC 0.37 NFRC 90 New Milgard Classic Low -E Vinyl Zone 1 4 Window 50.5 0.390 NFRC 0.37 NFRC 0 New Milgard Classic Low -E Vinyl Zone 1 5 Skylight 8.0 0.550 Default 0.55 Default 90 New Double Non Metal Tinted Zone 1 (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS Window ID Exterior Shade Type SHGC H t Wd Ove hang Left Fin Right Fin Len H t LExt RExt Dist Len H t Dist Len H t 1 Bug Screen 0.76 2 Bug Screen 0.76 3 Bug Screen 0.76 4 Bug Screen 0.76 5 None 1.00 Ene Pro 5.1 by EnergySoft User Number: 5750 RunCode: 2012-05-10710:52:36 ID. 1142 Page 6 of 17 CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -1 R Project Name PHAN'S RESIDENCE Building Type © Single Family ❑ Addition Alone ❑ Multi Family m Existing+ Addition/Alteration Date 5/10/2012 BUILDING ZONE INFORMATION System Name Zone Name New Floor Area Existing Altered Removed Volume Year Built HVAC System Room 1 2,291 19,932 2012 Totals o 0 2,291 0 HVAC SYSTEMS System Name Qty, Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC System 1 Central Furnace 80% AFUE Packaged Air Conditione 14.0 SEER Setback Existing HVAC DISTRIBUTION System Name Heating Cooling Duct Duct Location R -Value Ducts Tested? Status HVAC System Ducted Ducted Crawlspace 8.0 ❑ New El El WATER HEATING SYSTEMS S stem Name oty Ty e Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE Standby Loss or Pilot Ext. Tank Insul. R- Value Status Rheem 41 VRP50PT 1 Small Gas Kitchen Pipe Ins 40,000 50 0.65 n/a n/a Existing MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length (ft) c 0 Q — System Name Pipe Length Pipe Diameter Insul. Thick. Qty. HP Plenum Outside Buried ❑ EnergyPro 5.1 by EnergySoft User Number. 5750 RunCode: 2012-05-10T10:52:36 ID. 1142 Pae 7 of 17 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R Project Name PHAN'S RESIDENCE Date 5/10/2012 NOTE: 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 -1 R, CF -1 R -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 -1 R Form with plans. Building Envelope Measures: 116 (a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of 10-111 (a). 117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed. 118(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form. §118(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(i) when the installation of a Cool Roof is specified on the CF -1 R Form. 150(a): Minimum R-19 insulation in wood -frame ceiling orequivalent U -factor. 150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value. 150(c): Minimum R-13 insulation in wood -frame wall orequivalent U -factor. 150(d): Minimum R-13 insulation in raised wood -frame floor orequivalent 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 absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance rate is no greater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: 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 tight -fitting damper and or a combustion -air control device. §150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System 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. 150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA. 150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1506)1 A: 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. §1506)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. §1506)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 150-13. §1506)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. §1506)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. 1 50 ' 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 -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro5.1 by EnergySoR User Number: 5750 RunCode: 2012-05-10710:52:36 ID: 1142 Page 8 of 17 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R Project Name Date PHAN'S RESIDENCE 5/10/2012 §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 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 inch, the combination of mastic and either mesh or tae shall be used §150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150(m)2D: Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tae is used in combination with mastic and draw bands. 150(m)7: Exhaust fans 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)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with 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(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(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 ora pilot light. §114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return lines, or built-up connections for future solar heating. 114(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 ro rammed to run only during off-peak electric demand periods. 150 : Residential pool systems orequipment meet the pump sizing, 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 the efficacies contained in Table 150-C and is not a low efficacy luminaire asspecified by §150(k)2. 150(k)3: The wattage of permanently installed luminaires shall be determined asspecified by §130(d). §150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line - voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a medium screw -base socket. 150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k). 150(k)7: All switching devices and controls shall meet the requirements of §150(k)7. §150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a manual -on occupant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. EnergyPro 5.1 by EnergySoft User Number: 5750 Run Code: 201 2-05-1 0 71 0:52:36 ID: 1142 Page 9 of 17 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R Project Name Date PHAN'S RESIDENCE 5/10/2012 §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)11 : Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual - on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply with §150 k 11. §150(k)l2: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing and ceiling. §150(k)l3: 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 (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptionl to §150(k)13 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not be high efficacy luminaires. §150(k)l4: 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)15: 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: 5750 RunCode: 2012-05-10710:52:36 ID: 1142 Page 10 of 17 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Date PHAN'S RESIDENCE 5/10/2012 System Name Floor Area HVAC System 2,291 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL CFM Total Room Loads 1,148 Return Vented Lighting COOLING PEAK COIL HTG. PEAK Heating System Sensible Latent CFM Sensible Output per System 39,400 18,530 1,174 319 24,618 Total Output (Btuh) 39,400 0 Output Btuh/s ft 17.2 Return Air Ducts Return Fan Ventilation 0 Supply Fan 510 1,145 Cooling System 0 0 Output per System 24,900 0 0 0 0 Total Output (Btuh) 24,900 744 -744 Total Output (Tons) 2.1 Supply Air Ducts 510 1,145 Total Output (Btuh/s ft) 10.9 Total Output s ft/Ton 1,104.1 TOTAL SYSTEM LOAD 20.293 1,174 26,164 Air System CFM per System 800 HVAC EQUIPMENT SELECTION Airflow cfm 800 Carrier 48PGN-03--3 17,304 7,202 39,400 Airflow (cfm/s ft) 0.35 Airflow (cfm/Ton) 385.5 Outside Air (%) 0.0 % Total Adjusted System Output 17,304 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK 7,202 Aug 3 P7 39,400 Jan 1 AM Outside Air (cfm/s ft) 0.00 Note: values above given at ARI conditions HEATING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Heating Peak) 28 IF 67 IF 140 °F 141 °F Outside Air 0 cfm Heating Coil Supply Fan 140 IF 800 cfm ",1F7 �OOM._. -' 67 OF 68 IF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak) 88 / 68 of 75 / 64 OF 59 / 58 OF 60 / 58 IF Outside Air 0 cfm Cooling Coil Supply Fan 60 / 58 OF ai)o cfm 54.6% g�� " ROOM Y� 75 / 64 OF � I 751 64 OF EnergyPro 5.1 by EnergySoft User Number: 5750 RunCode: 2012-05-10T10:52:36 ID: 1142 Page 11 of 17 ROOM LOAD SUMMARY Project Name Date PHAN'S RESIDENCE 5/10/2012 System Name Floor Area HVAC System 2,291 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK I COIL HTG. PEAK Zone Name Room Name Mult. CFM I Sensible T Latent CFM Sensible I Latent I CFM Sensible Zone 1 Room 1 1 1.1481 18,5301 1,174 1,148 18,5301 1,1741 319 24,618 PAGE TOTAL TOTAL" 1.148 18, 530 1,174 319 24, 618 1,148 18,530 1,174 319 24,618 Total includes ventilation load for zonal systems. EnergyPro 5.1 by EnerqySoft User Number, 5750 Run Code: 2012-05-10710:52:36 ID: 1142 Pae 12 of 17 ROOM HEATING PEAK LOADS Project Name PHAN'S RESIDENCE Date 5/10/2012 ROOM INFORMATION DESIGN CONDITIONS Room Name Room 1 Floor Area 2,291.0 ft2 Indoor Dry Bulb Temperature 68 OF Time of Peak Jan 1 AM Outdoor Dry Bulb Temperature 28 OF Conduction Area X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X to Ceiling U -Value X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X AT 'F = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = 40 Btu/hr R-19 Floor Crawlspace 2,291.0 0.0370 40 3,391 R-13 Wall 1,567.5 0.1020 40 6,395 Milgard Classic Low -E Vinyl 344.3 0.3900 40 5,371 Wood Door 42.0 0.5000 40 840 R-30 Roof Attic 2,283.0 0.0310 40 2,831 Double Non Metal Tinted 8.0 0.5500 40 176 Items shown with an asterisk (') denote conduction Infiltration:[ 1.00 X 1.077 Schedule Air Sensible Fraction through an interior surface X 2,291 X Area another room 8.70 X 0.392 Height ACH Page Total /60] X AT 19,004 = 5,614 TOTAL HOURLY HEAT LOSS FOR ROOM 24,618 EnergyPro 5.1 by EnergySoft User Number. 5750 RunCode: 2012-05-10710:52:36 ID: 1142 Pae 13 of 17 RESIDENTIAL ROOM COOLING LOAD SUMMARY Project Name Date PHAN'S RESIDENCE 5/10/2012 ROOM INFORMATION DESIGN CONDITIONS Room Name Room 1 Outdoor Dry Bulb Temperature 88 OF Floor Area 2,291.0 ft' Outdoor Wet Bulb Temperature 68 OF Indoor Dry Bulb Temperature 75 OF I Outdoor Daily Range: 30 OF Opaque Surfaces Orientation Area U -Factor CLTD' Btu/hr R-19 Floor Crawlspace 2,291.0 X 0.0370 X 4.0 = 339 R-13 Wall (Wj 243.5 X 0.1020 X 13.0 = 323 Wood Door 42.0 X 0.5000 X 13.0 = 273 R-13 Wall (S) 403.0 X 0.1020 X 6.0 = 247 R-13 Wall (E) 352.0 X 0.1020 X 13.0 = 467 R-13 Wall (N) 569.0 X 0.1020 X 3.0 = 174 R-30 Roof Attic (E) 2,283.0 X 0.0310 X 37.0 = 2,619 X X = X X = Page Total 4,441 Items shown with an asterisk (`) denote conduction through an interior surface to another room. 1. Cooling Load Temperature Difference (CLTD) Shaded Unshaded Fenestration Orientation Area GLF Area GLF Btu/hr Window (W) 0.0 X 14.9 + 86.3 X 37.4 = 3,227 Window (S) 0.0 X 14.9 + 133.5 X 20.5 = 2,732 Window (E) 0.0 X 14.9 + 74.0 X 37.4 = 2,767 Window (N) 0.0 X 14.9 + 50.5 X 14.9 = 751 Skylight (E) 0.0 X 22.9 + 8.0 X 100.2 = 802 X + X = X + X - X + X - X +1 X - Page Total 10,278 Internal Gain Btu/hr Occupants 4.0 Occupants X 230 Btuh/occ. = 920 Equipment 1.0 Dwelling Unit X 1,600 Btu = 1,600 Infiltration: 1.077 X 0.65 X 141.86 X 13 = 1,291 Air Sensible CFM ELA AT TOTAL HOURLY SENSIBLE HEAT GAIN FOR ROOM 18,530 Latent Gain Btu/hr Occupants 4.0 Occupants X 200 Btuh/occ. = 800 Infiltration: 4,830 X 0.65 X 141.86 X 0.00084 = 374 Air Sensible CFM ELA AW TOTAL HOURLY LATENT HEAT GAIN FOR ROOM 1.174 EnerqyPro 5.1 by EnerqySoft User Number: 5750 Run Code: 2012-05-10T10:52:36 ID: 1142 Pae 14 of 17 ENERGY USE AND COST SUMMARY ECON-1 Project Name PHAN'S RESIDENCE Date 5/10/2012 Rate: Fuel Type: Electricity STANDARD PROPOSED MARGIN Energy Use (kWh) Peak Demand Cost kW $ Energy Use kWh Peak Demand kW Cost $ Energy Use kWh Peak Demand Cost kW $ Jan 110 1 101 1 9 0 Feb 78 2 67 2 11 0 Mar 59 2 54 2 6 0 Apr 74 3 62 2 12 1 May 35 4 28 3 7 1 Jun 109 5 91 4 19 1 Jul 147 5 121 4 26 1 Aug189 6 158 5 31 1 Sep 122 7 102 6 20 1 Oct 56 4 46 4 10 0 Nov 70 1 62 1 7 0 Dec 109 1 99 1 10 0 Year 1,159 7 991 6 169 1 CO2 lbs/ lbs/yr lbs/yr Rate: Fuel T e: Natural Gas STANDARD PROPOSED MARGIN Energy Use therms Peak Demand Cost kBtu/hr $ Energy Use (therms) Peak Demand kBtu/hr Cost $ Energy Use therms Peak Demand Cost (kBtu/hr)$ Jan 94 70 87 69 7 0 Feb 62 61 59 61 4 0 Mar 53 58 50 59 3 -1 Apr 45 50 43 52 2 -1 May 22 42 22 44 0 -2 Jun 20 26 20 27 0 -1 Jul 20 6 20 6 0 0 Aug19 5 19 5 0 0 Sep 191 5 19 5 0 0 Oct 24 46 23 46 1 0 Nov 61 63 57 63 4 0 Dec 93 72 85 71 7 1 Year 532 72 504 71 28 1 CO2 lbs/yr lbs/yr I lbs/yr Annual Totals Energy Demand Cost Cost/s ft Virtual Rate Electricity 991 kWh 6 kW $ 0 $ 0.00 /s ft $ 0.00 /kWh Natural Gas 504 therms 71 kBtu/hr $ 0 $ 0.00 /s ft $ 0.00 /therm Total $ 0 $ 0.00 /s ft Avoided CO2 Emissions: 0 lbs/yr EnergyPro5.1 by EnergySoft User Number. 5750 RunCode: 2012-05-10T10:52:3 ID: 1142 Page 15 of 17 Energy Upgrade Recommendations ECON-2 Project Name PHAN'S RESIDENCE I Documentation Author STUDIO 61 ARCHITECTS INC Project Address 866 LILYAVENUE CUPERTINO, CA 95014 ents Annual Results Energy Cost End UseExistin Improved Savings Space Heating 70 Space Cooling 0 Fans $0 Pumps Domestic Hot Water $0 Indoor Lighting $0 Outdoor Lighting Appliances/Plug Loads $0 Ancilla $0 Renewables 1 $0 TOTAL I Sol I CO2 lbs! ear Existing Improved Savings Electricity 0 Fossil Fuel 0 TOTAL 0 Author Address 12480 SARATOGA AVE SARATOGA, CA 95070 Annual I Est. Cost to Site I TDV Fossil Fuel (therms) I Climate Zone: 4 Electric Rate: Gas Rate: Floor Area: Type:Single Family TDV Energy (kBtu/ft`-yr) I I-- I I I The estimated operating costs shown in this report are dependent upon many factors. The construction and conservation features of the project clearly are important. Equally important is the thermostat setting. How the thermostat is used, appliance use and occupant interaction all influence the annual operating cost. The estimates provided in this report are based on typical conditions, your actual usage will vary. EnergyPro 5.1.6.7 by EnergySoft User Number. 5750 RunCode: 2012-05-10710:52:36 ID. 1142 Page 16 of 17 UTILITY INCENTIVE WORKSHEET UTIL-1 R Project Name Date PHAN'S RESIDENCE 5/10/2012 ANNUAL TDV ENERGY USE (kBtu/s ft- r) PERCENT BELOW Mar in Standard TITLE 24 % Better' ENERGY COMPONENT Standard ProDosed Mar in 20.04 18.13 1.91 3.78 / 1 46.41 - F-8.2% Space Heating Space Cooling 6.29 4.97 1.31 Coolin Standard Heat Rejection 0.00 0.00 0.00 1 1.31 Indoor Fans 4.52 3.96 0.56 Incentive Eligibility Yes No Domestic Hot Water 15.56 15.56 0.00 Owner Incentive (>=15%) ❑ m Pumps 0.00 0.00 0.00 NSHP Incentive (>=30%) ❑ m Conditioned Floor Area = 2,291.0 ftz TOTALS: 46.41 42.62 3.78 Number of Bedrooms = 3 Energy Star V3 Target = 16% ANNUAL SITE ENERGY USE Average Standard Proposed Margin Single Orientation Peak kW 3.4 1 2.71 1 0.7 Standard Proposed Margin ENERGY COMPONENT Electricity Natural Gas Electricity Natural Gas Electricity Natural Gas (kWh) (therms) kWh therms kWh therms Space Heating 0.00 291.62 0.00 263.73 0.00 27.90 Space Cooling 496.80 0.00 395.97 0.00 100.83 0.00 Heat Rejection 0.00 0.00 0.00 0.00 0.00 0.00 Indoor Fans 662.66 0.00 594.97 0.00 67.69 0.00 Domestic Hot Water 0.00 240.28 0.001 240.28 0.00 0.00 Pumps 0.00 0.001 1 0.00 0.00 0.00 0.00 TOTALS: 1,159.46 531.90 1 990.94 504.00 168.52 27.90 POTENTIAL OWNER INCENTIVE CALCULATION Potential incentives indicated % Better than Title -24' Incentive Savings on this report are available (from ste 2) Rate (from Step 3 Subtotal x only through the California Electricity (kWh) n/a n/a Advanced Homes Program for $/kWh kWh new construction and are Electricity (kW) x NOT GUARANTEED. Projects $/kW kW must meet all other program n/a n/a n/a Natural Gas x �� = r� L_n/a requirements to qualify. Potential incentives are snnem therm subject to program limitations Base Incentive Pacific Gas and Energy Star Incentive n/a x 10% Electric Company Green Home Incentive n/a x 10% sol-IMI,y CAu OR',,lA ED I S O N Compact Home Incentive n/a x 15% Photovoltaic Incentive n/a x n/a = n/a SC L DC Rating kW A SempraEnergyutaty` NSHP n/a fr o.� Total advanced, ,erne -d tnerg� ,nNq % Better than in this equation is limited to 45% EnergyPro5.1.6.7 by EnergySoft User Number: 5750 RunCode: 2012-05-10T10:52:36 ID. 1142 Page 17 of 17 I