Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
12080143
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 12 RESULTS WAY CONTRACTOR: XL CONSTRUCTION PERMIT NO: 12080143 OWNER'S NAME: ECI TWO RESULTS LLC 851 BUCKEYE CT DATE ISSUED: 12/14/2012 OWNER'S PHONE: 4084901641 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 ❑ LICENSED CONTRACTOR'S DECLARATION License Class. Lic. # `fq6o Contractor kL ( 0 W°j;IVUQirJ 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, th applicant understands and will comply with all non -point so ce regula ons pe the Cupertino Municipal Code, Section 9.18. Signature f 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the 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, 1 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. BUILDING PERMIT INFO: BLDG ELECT F PLUMB r MECH T_ RESIDENTIAL f— COMMERCIAL JOB DESCRIPTION: APPLE - COMMERCIAL TENANT IMPROVEMENT (31,532 SQFT)-NEW INTERIOR PARTITIONS,DOORS,FINISHES, CEILINGS,LIGHTING-NON-STRUCTURAL, INCLUDES Sq. Ft Floor Area: I Valuation: $3000000 APN Number: 35720046.00 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: v/ 4 �Date: /,7 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(x) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by eBay Area Air Quality Management District I will maintain com li ce with a Cupertino Municipal Code, Chapter 9.12 and the Health & S wCCode, S ctions 2,5505, 25533, and 25534. Owner orizedfie nt: ~ r4yll Date: l 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. Signature Date I Licensed CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building-)cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION X❑ ALTERATION / TI ❑ REVISION/ DEFERRED ORIGNAL PERMIT # PROJECTADDRESS 12 Results Way 7APNI 357 20 046 OWNER NAME EC I TWO RESULTS LLC PHONE 408.490.1641 E-MAIL STREETADDREss1301 SHOREWAY RD STE 250 CITY, STATE, zIPBelmont CA 94002 FAX CONTACT NAME Marco Innocenti PHONE 408.240.6000 E-MAIL minnocenti@xlconst.com STREETADDRESs 851 Buckeye Court CITY,STATE, ZIP Milpitas, CA 95035 FAX 408.240.6001 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT EI CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Marco Innocenti LICENSE NUMBER 6 4 7 4 8 0 LICENSE TYPE B BUS LIC # 21836 COMPANYNAME XL Construction E-MAIL minnocenti@xlconst.com FAX 408.240.6001 STREETADDRESS 8551 Buckeye Court CITY, STATE,ZIPMilpitas, CA 95035 PHoNF408.240.6000 ARCI-IITECT/ENGINEER NAME David SabalVarO LICENSE NUMBER C-015925 BUS LIC # COMPANY NAME Studios Arch E-MAllcrossman@studiosarch. com FAX 415.398.3829 STREETADDREss405 Howard St Suite 588 CITY, STanPFrancisco, CA 941051 PHONE415.398.7575 DESCRIPTION OF WORK New interior partitions, doors, finishes, ceilings, lighting, electrical, mechanical, and plumbing. EXISTINGUSE Business Group B PROPOSED USE CONSTR Business Group B III TYPE NR 1 # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION($) EXISTG AREA 31, 5321AREA I NEW FLOOR 31, 532 I DEMO 1.AREA N/A TOTAL NETAREA31, 532 ��.. 043 /3 Oc"--o6o BATHROOM N/A KITCHEN N/A OTHER N/A REMODELAREA REMODELAREA REMODELAREA PORCH .AREA N/A DECK AREA N/A TOTAL DECK/PORCH AREA N/A I GARAGEAREA. DETACH N/A C] ATTACH #DWELLING UNITS IS A SECOND UNIT ❑YES SECOND STORY C] YES N/A BEING ADDED? NO ADDITION? ®NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY: TAL VALUATION: TOTAL PLANNING APPL # UNO PLANNING APPROVAL LETTER EICHLER HOME? 14 NO 3 0 00,000 By my signature below, I certify to each of the fo lowing: I am the prope owner or thorized agent to act on the property owner's behalf. I have read this application and the information I have provided s c ect. I have read t escriptio f Work and verify it is accurate. I agree to comply with all applicable Iocal ordinances and state laws relating to building ns coon. I authorize esentativ f Cupertino to enter the above -i ledp perty for inspection purposes. .12 Signature of Applicant/Agent: Date: SUPPLEMENTAL INA RNKTION REQUI IfD PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellin s: Apply for demolition permit for LDINGPLAN R>avlEty existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS 2 PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure &-9 ANDARD ❑ PUBLIC woRKs form if any Hazardous Materials are being used as part of this project. ❑ LARGE _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR nSTARYSEWERDISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH 81dgApp_2011.doc revised 06/21,11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 12 results way TYPE OF CONSTR. DATE: 08/13/2012 REVIEWED BY: bobs. AWADDRESS: APN: BP#: , �� B (Tenant Improvements) *VALUATION: 1$3,000,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIINSP $0.00 PME Plan Check: PENTAMATION 1 B TI PERMIT TYPE: WORK t.i. comm offices ace non structural includes M E,Ps. SCOPE Permit Fee: $11,853.16 Suppl. Insp. Fee -(j) Reg. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-BjV,v-B 31,532 $3,337.96 IBTIPLNCK $11,853.16 IBTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $11,853.16 Suppl. Insp. Fee -(j) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 31,532 $3,337.96 $11,853.16 MECH, HOURLY 0 Yes G No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY 0 Yes 0 No NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt otn )_ Thew fooc are havod an the nroliminary infarmation availahle and are only an estimate Contact the Dent for addn'l info. FEE ITEMS Fee Resolution 11-053 E,f 7/1,11) FEE QTYIFEE MISC ITEMS Plan Check Fee: $3,337.96 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. 0 OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $11,853.16 Suppl. Insp. Fee -(j) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 E) Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) A .., Strong Motion Fee: 1BSEISMICO $630.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $120.00 SUBTOTALS: 15,941.12 $0.00 TOTAL FEE: $15,941.12 Revised: 07/01/2012 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: ,-J I LAG—j S ,� PERMIT # '-ZC&01 Q 1 L4 44 OWNER'S NAME: PHONE # GENERAL CONTRACTOR:u BUSINESS LICENSE # ADDRESS: 1 C "UC -A CITY/ZIPCODE: D *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 Date Please check applicable subcontractors and complete the following information: O er Contra or Signature Date r SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation v Fencing Flooring / Carpeting h -z Linoleum / Wood Glass / Glazing c , Heating i� h_h►tl !'C�. L -7 Insulation Landscaping Lathing Masonry Painting/ Wallpaperr- Paving Plastering Plumbing N i \V E_ C f' . 36 Roofing Septic Tank Sheet Metal Sheet Rock S t gra `l Tile -Z'3-53 O er Contra or Signature Date r 2010 CALGREEN NON-RESIDENTIAL CHECKLIST - MANDATORY ITEMS 1� I COMMUNITY OF-VELOPMENT DEPARTMENT - BUILDING DIVISION CUPERTINO AL13ERT SALVADOR, RE_ G B,G, BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, GA 95014-3255 (408) 777�3228, FAX (408) 77? -33-'43 0 bi ou 1 PURPOSE: The non-residential provisions of the 2010 CalGreen Code a tinning, design and development methods that include environmentally responsible site selection, build -Ing design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material. conservation and resource efficiency; and outlines means of reducing the quantity of aircontaminants. Project Name: Project Address: Project Desc:r1ption.-1eva_v_J_r,_Am1 instructions: 0 1. The Owner of the Comer's agent shall employ a licensed professional experienced with the 2010 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the orwner and the design professional shall initial Column 2 of t sign and date FR'V"40 Verification at the end of this checklist and have ited an the a 4 ciid , the Building ntg,kie icensed professional shall complete Column 3 3. Prior to final in 0 repaNd tfitenproject and sign and d 2 - Implementation Verification at the end of this checklist and submit the completedfora; ding*Fp4cJ_rjflJ2 REV!lt_VVtL) t-Ut% 1. Column 2 1 Column 3 MANDA,ToQi@We61 TURE 0 Project Verification Requirements I General Requirements The project meats all the requirements of Divisions 5.1 through 5,5. 1 EJ 1 13 Planning and Design - Site Development 5,106.1 Storm water pollution prevention plan. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been designed, specific to its site, conforniing to the Slate Storm water NP DES Construction Permit or local ordinance, whichever is stricter, as is required for El projects over one acre. The plan should cover prevent on of soil loss by storm teeter run-off andI'or wind erosion, of sedimentation and/or of dust;particu late matter air pollution, llzgc 1 0* -9 ra[Gme);Alon- Rfs ChecA-Ifsr, do, revised ", 127111 5.1016.4 Bicycle parking and changing rooms Comply with Sections � El .5.1013,4.1 and 5.1 OF.h 2; or meet local ordinance. whi.:hewer is stricter. 5.106.4.1 Short-Terre bicycle parking. If the project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the vis ors' entrance, readily visible to passers-by, for 5 percent of visitor motorized i~tehloe parking capacity, with a minimum of a e two- bike capacity rants. 6.10£.4.2 tong-Term bicycle parking: For bui_idings with over 10 tenant- occupants, provide secure bicycle parking for 5 percent of tenant-occupied motorized vehicle parking capacity, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low-emitting, fuel-efficient sand carpDolivan pool vehicles as �' shown in Table 5.106.6Z 5.106.8 Light pollution reduction. Comply Nvith lighting power requirements in the Cohfbmia Energy Godo and design interior and exterior Ilghting such that zero direct-beam illumination leaves the building site. {Fleet or exceed exterior n light levels and uniformity ratios for lighting zones 1 —4 as defined in Chapter 10 of the C'aliforatl Administrat ve Code, using the following strategies: 1. Shield all exterior luminaires or use cutoff i uminaires. 2. Contain interior lighting within each source. i V 3. Allow no mare than ,01 horizontal foot candle 15 It beyond the site, 4. Contain all exterior lighting within property boundaries. M Exception: See Part 2, Chapter 12, Section 1205.6 for carnpus'ighting requirements for parking facilities and walkways, 6,106.10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plaits shall indicate how � Q site grading or a drainage system will manage all surface water flows, Division 5.2 ENERGY Performance Requirements 5.201.1 Scope. The California Energy Commission will continue to adopt rmandatory building standards.t lvision 5.3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 5.363,1 Meters. Separate meters shall be installed for the uses described in Sections 503,1.0 through 503.1.3. 5„3011.1 Buildings in excess of 50,DCO square feet. Separate submeters shall be installed as follows, 1. For each individual leased, rented or other tenant space'.within the ;< buiidin rc acted to consume more than 100 calldzav Piigc 2 ril`il Ch ckdisr,dr.�c revisedf�_� �i,'a 2. For spaces used for lauridry or cleaners, restaurent or food service, medical or dental office, laboratory or beauty salon or barber shop M projected to consume more than 100 gallclay. 5,303.1.2 Excess consumption. Any building within a project or space witnin a building that is projected to consume more than 1,000 gal/day. 6.303.2 20 percent savings. A schedule of plumbing fixtures and fixture Lai fittings that will reduce the overall use of potable water within the building by 20 percent shall to provided, (Calculate savings by Water Use Worksheets) 5.303.2.1 Multiple showerheads serving one shower, When single shower fixtures are served by rnore than one shrawerhead, the combined flaw rate of all the shm verheads shalt .not exceed the maximum flow rates -1/1 VLai specified in the 20 percent reduction column contained in Table 5,303.2.3 or :he shower shall be clesigne,i to only allow one shmverhead to be in operation at a time, 5.303.4 Wastewater reduction. Each building shall reduce the generation of wastewater by one of the following methods; As applicable 1. The installation of water-conserving fixtures or UN-1' 2_ Utilizing non-potable water systems, 171-111 5.303.6 Plumbing fixtures and fittings. Plumbing fixtures (water closets and ur'nals) and fittings (faucets arid showerheads) shall comply with -he requirements listed for each type in Items listed in Table 5.303,6. As applicable 1, Water closets (toilets) - flushometer type l=t 2. Water closets (toilets) - tank type 0 3. Urinals Q 11 4, Public lavatory faucets 5. Public metering self-closing faucets ®] 6. Residential bathroom lavatory sink faucet R-11 [� 7. Residential kitchen faucets 0 3. Residential shover heads E 9. Single shower fixtures served by more than on showerhead 0 Outdoor Water Use 5.304.1 Water budget. A water budget shall be developed fm landscape u irrigation use, 5.3014.2 Outdoor potable water use. For new water service, separate meters or submeters shall be installed for indoor and outdoor potable water use for landscaped areas betraeen 1,000 square feet and 5,000 square feet. 5.304.3 Irrigation design, In new nonresidential protects with between 1,000 As applicable and 2,500 square feet of landscaped area (the level at which the MIL© applies), install irrigation controllers and sensors which include the following criteria and meet nianufactufer's recommendations. Il age 3 of 9 C:"a"Green Non -Res 6.304.3.1 Irrigation controllers. Automatic irrigation system conlroliers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil molsture-based controllers that 1171-711 automatically adjust Irrigation In response to changes in plants' needs as weather conditions change. 2. Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates LAJ with the oxntroller(s). Soil moisture -based controllers are not required to have rain sensor input. Weather Resistance and Moisture Management 5.407.1 Weather protection. Provide a weather -resistant exterior w2il and foundation envelope as required by C91ifbi-nia Buddiag Cod6 Section 1403.2 and California EneTy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent' 5.407.2 Moisture control. Employ moisture control measurer, by the following methods; 5.407.2.1 Sprinklers, Prevent irrigation spray on structures. 5.407.2.2 Entries and openings. Design exterior entries and openings to L^j LJ prevent water intrusion into buildings. Construction Waste Reduction, Disposal and Recycling 5.408.1 Construction waste diversion. Establish a construction waste management pier or me41 meal ordinance, whichever is more stringent. __. . ............. . .... . _ .. . . . ... .................... 5,408.2 Construction waste management plan. Sul nijt plan per this section to enforcement authonly. 5.408.2.1 Documentation. Prvcde documentation of the waste management plan that meets the requiremerts listed in Section 5AG8.2 Items I thru 4 and the plan is accessible to the enforcement authority. 5.408.2.2 Isolated Jobsites. The enforcing agency may niake exaeptlms to the requirements of thin sel-Lion v/hen jobsites are located in areas be,-y,ond the haul boundaries of the dlversi2n_facilit .... 5.408.3 Construction waste. Recycle andlor salvage for reuse a minimum of 50 percent of nonhazardous constru-:ftri and demolition debris or meet local ordinance, whichever is more stringent. Exceptions. 1. Excavated soil and land -clearing debris, 2. Alternate waste reduction methods develolped by working with local agencies if diversion or recycle facilities capable of compliance with T is item do not exist. 5.408.4 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land Lai clearing shall be reused or recycled. Page 4 vi'9 CedGrern Xon-Ries !,r%4nd Ox 2711 Building Maintenance and Operation 5.410.1 Recycling by occupants..Provide readily accessible areas that serve the entire building and are identified for the depositing, starage and collection of nonhazardous materials for recycling. " 5.410.2 Commissioning. For new buildings !0,000 square feet and aver, building corntrissivning for all building systems covered by T24, mart 6, process systems and renewable energy systems shall be included in the Q design and construction processes of the building project. Commissioning requirements shall include iterns listed in Section 5.4110.2, 5.410.2.1 Owner's Project Requirements (OPR). Documented oefore the design phase of the project begins the CPR shall include items listed in r� Fri Section 5.410.4, 5.410.2.2 Basis of Design (BCD). A tiwrftien explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems listed n Section 5,410.2.2. 6.410.2.3 Commissioning plan. A oornmiss=oning ,plan describing hma the project will be oomrnissioned shall be started during the design phase of K111 u the building project and shall include items, listed in Section 5.410.2,3. 5.410.2.4 Functional performance testing shall demonstrate the correct installation and operation of each component, syste=m and system -to- M system interface In accordance with the approved pians and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems operations training are required. t�t 1x1 5.410,2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall include the items listed in Section 5,410.2,5.1 . 5,414.2.5,2 Systems operations training. The training of trio appropriate maintenance staff for each equipment type anftr system shall include items listed in Section 5.410.2.5.2. 6.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and reporting recommendations for post-conrruction phases of the building I� 1^_[ ri projiect shall be completed and provided to the owner or representative. 5,410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet. 6.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems, Systems to be included for testing and ad.usting shall include, as applicable to the project, tie systems listed in Sectior 5.410.3,x. 6.410.4.3 Procedures. Perform tasting and adjusting procedures in accordance with industry best practices and aoplicabie national standards on each system. 5,4111.4.3,1 HVAC balancing. Before a new space -conditioning systern serving a building or space is operated For noarmaI use, the system should be balanced in accordance with the procedures defined by national standards listed in Section 5.410.3.3.1. Ps2c 5 or f'rrt{li°een P.on--#acs Yvvi `cd 08.77'Y1 6.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed opera!ing and maintenance instructions and copies of quarantiesh,varranties for each system prior to final inspection, k:IJ 5,410.4.5.1 Inspections and reports. Inclu-de a copy of all nspectlon M%/ verifications and reports required by the enforcing agency, 14^J Fireplaces 6.503.1 Install only a direct -vent sealed -combustion gas or sealed wood- "U burning fireplace or a sealed woodstove and refer to residential requirement", in the California Energy Cade, Title 24, Part 6, Subchapter 7, Section 150. 5.503.11 Woodstoves, Woodstoves shall comply with US EPA Phase H emiss=on limits. k:IJ Pollutant Control 6.504.3 Covering of duct openings atid protectlon of mechanical equipment during construction. At'the time of rough installation or during storage on the constructon site and until final startup of the heating and cooling equipment, all duct and other related air distribution component openings shall be covered will tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Fnish materials shall comply with Sections 5.504.4.1 through 5.504,4,4, 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards, 1. Adhesives, adhesive bonding printers, adhesive primers, sealants, sealant primers and caulks shall Comply With local or regional air pollution control or air quality management district rules where applicable or rM Lai El SCACMD Ririe 1166 VOC limits, as sh%vn in Tables 5.504.4,11 and 5,504,4.2- 2, Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking COMPOUndS (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and othe- requireme,its, including prohibitions on use of certain toxic compounds, of Calitarnia Code of RogWations. Title, 17, commencing with Section 94507, 5.504.4.3 Paints and coatings. Architectural paints and coatings shall comply with Table 6,504-4.3 unless more stringent local linnits apply, 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on tse of 11"M certain toxic compounds and ozone depleting substances (CCR, Title 17. Section 94520 el seq). Page 6 01'9 CalGvvn Nati-Pes Checl-hn.doc +,ev(Npd 11 5.504.4.3.2 Verification, Verification cf compliance with alis section shall be provided at the request of the enforcing agency. 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of one of the standards listed in Section 5.504.4.4, 5.604.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute Green Label program. 5.504.4.4.2 Carpet adhesive. All carpet adhesive shalt meet the requirements of Table 804.41. 6.604.4.6 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for formaldehyde as specified In Table 5.504 4, 5,504.4.5.2 Documentation. Verification of compliance with this section shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following; `, Product certifications and specifications 2. Chain of custody certifications 3. Other methods acceptable to the enforcing agency 5.504.4.6 Resilient flooring systems. Comply with the VOC-emission limits defined in the 2009 CHP'S criteria and listed on its Low -emitting Materials List (or Product Registry) or certified under the FloorScore program of the Resilient Floor Covering Institute. 5.504.5.3 Filters. 1n me&anically ventilated buildings, provide regularly occuipied areas of the building with air filtration media for outs+de and return air prior to occupancy that provides at least a MERV of 8- 6.604.7 Environmental tobacco smoke (ETS) control. Prohibit smoking Within 25 $eet of building entries, outdoor air intakes and cperable windows 1AMere outdoor areas are provided for snaking and in buildings; or as enforced by ordinances, regula0uris or policies of any city, county. city and county, California Community College, campus of the California State University or campea of the University of California, whichever ,are niore stringent. Indoor Moisture and Radon Control 5.505.4 Indoor moisture control. Buildings shall meet or exceed the provisions of California Buildhig Code, CCR, Title 24, Part 2. Sections 1203 and Chapter 14.1. Air Quality and Exhaust 5.606.4 Outside air delivery. Fear mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the Cafiforrtia Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 6 or the applicable local code, whichever is rimore stringent.' 11age 7 of Co,'Gr,en-,ro-Ro.N Cherkhvi.doc eeviy d *.S1741 L^.J Cl El E As applicable El El 13 0 11 11age 7 of Co,'Gr,en-,ro-Ro.N Cherkhvi.doc eeviy d *.S1741 5,606.2 Carbon dioxide (CO2) monitoring, For buildings equipped with demard control ventilation, CO2 sensors and ventilation controls shalt be specified and installed in accordance with the requirements of the latest edition of the California Energy Code, CCR, Title 24, Part 6, Section 121 (c),' Environmental Comfort 5.507.4 Acoustical control. Employ budding assemblies and components M./I with STC values determined in accordance with ASTM E 90 and ASTM E 413 6.607.41 Exterior noise transmission. Wall and fIcar-ceiling, assemblies making up the building envelope shall have an STC of at (east 50 and exterior windows shall have a minimum STC of 30 for any of the building locations listed in Items 1 through 3 in Section 5,507,51. S.S07.4.2 Interior sound. Wall and floor -ceiling assemblies separating tenant spaces and tenant spaces and public places shall hmye an STC of ter at least 40. Outdoor Air Quality 5.508.1 Ozone depletion and global warming reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5,50&1.1 and 5,508.1.2. As applicable 5.508.1.1 CFCs. Install HVAC and refrigeration equipment that does not contain CFCs.' 6.608.1.2 Etalons. Install fire suppression equipment that does not Contain I Z El Ha(ons, I I 1, These nneasures are cur.enly reauxed elsewhere in statute or in regulatior. _Inge 5 Lif 9 , C CALGREEN SIGNATURE DECLARATIONS Project Naris: ?0_4'V'A 201 Project Address: W, Project Description; NPJA LA�� SECTION I - DESIGN VERIFICATION Complete all IfnesofSec*,1Dn 1I— `Doslgn Verification' and submit the completed checklist (Columns I and Z)wlih the plans and building permit applicatlon to the Building Degadment. '117111e owner and design professional respomible for compliance W111 CalGreen Standards have ravised the plans and certify that the items checked above are hereby Incorporated into the project plans and will be Implemented into the project In accordance with the requirements set faith In the 2010 California Green Building Standards Code as adopted by the City of Cupertino- / A afore --Dale, I Design Pro of Narne (Please Rdnt) -0-2 Z—L — lroressWn—el +onsible for (SAGreen compliance I k . Name of Lloense Professional reaponsibla for CalGreen cc-inpli3aw (Please P64t) Email Address for License Piofesslonalrespansible for Cal3reencompliance Il 2.jt1 7 - Date i B I Z104, Phone SECTION 2 - IMPLEMENTATION VERIFICATION Complete. sign and subm3 the competed checklist, including oulumn 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final Inspection. I have inspe0ed the work and have received sufficient documentation to verify and certify that the prqjecl idenfiried above was consliucled in accordance with this Green Buldirg Checklist acrd Iniaccordance with the raquiremeras or the 2010 California Green Building Standards Code as adapted by the 01yof Cupertino, I STonalure of License Professional responsible for CalGreen wrupflan;a Dale I Name of License Professional responsible for CatGreen compliance {Please Pdnt) Phone Page 9 GrIl calGreell ivroll-Ras L'tiect*51.6c rel4sedOV2711