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12080144CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 14 RESULTS WAY CONTRACTOR: XL CONSTRUCTION PERMIT NO: 12080144 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 5C LICENSED CONTRACTOR'S DECLARATION f— r BUILDING PERMIT License Classj/ _ Lic. # (O(-t q q bt-r INFO: BLDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL Xr - Contractor /� L t.0 NEER(�i67�/� Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: APPLE- COMMERCIAL TENENAT IMPROVEMENT (33,357 (commencing with Section 7000) of Division 3 of the Business & Professions SQFT) NEW INTERIOR PARTITIONS, DOORS, FINISHES, Code and that my license is in full force and effect. CEILINGS, LIGHTING NON-STRUCTURAL;fNCLUDES 1 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 Sq. Ft Floor Area: Valuation: $3000000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 35720041.14 Occupancy Type: APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may ac rue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this perm' . Addition Ily, t e applicant understands and will comply ' 180 DAYS FROM LAST CALLED INSPECTION. with all non-p t s rce regula ons p r the Cupertino Municipal Code, Section 9.18. • Signature Date Issued by:J✓ f�'✓ �% G�/ Date: %� ❑ OWNER-BUILDER DECLARATION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1 hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined y the y Area Air Quality Management District 1 will 1 certify that in the performance of the work for which this permit is issued, I shall wi the ertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's y Code, ectio 5505, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, I Vnmainta'coliance become subject to the Worker's Compensation provisions of the Labor Code, I must orize gen : " Date:. forthwith comply with such provisions or this permit shall be deemed revoked. `p CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of Aork's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(ftupertino.org Z' � of q -I ❑ NEW CONSTRUCTION ❑ ADDITION Q ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # ., PRO]ECTADDRESS 14 Results Way��?�� ���� �` ATN# 357 20 041 ; OWNER NAME ECI TWO RESULTS LLC PHONE 408.490.1641 E-MAIL STREETADDREss1301 SHOREWAY RD STE 250 CITY, STATE, ZIP Belmont 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 ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Marco Innocenti LICENSE NUMBER 6 7;7 48 0 LICENSE TYPE B BUS. LIC # 21836 COMPANYNAME XL Construction E-MAIL minnocenti@xlconst.com FAX 408.240.6001 STREETADDRESS 851 Buckeye Court CITY, STATE, ZIP Milpitas, CA 95035 PHONE408.240.6000 ARCHITECT/ENGINEERNAME David SabalVaro LICENSENUMBER C-015925 BUS LIC# COMPANYNAME Studios Arch E-M"'crossman@studiosarch.com FAX 415 . 398 . 3829 STREET ADDRESS 4 0 5 Howard St Suite 588 CITY, ST TE, ZIP San Francisco, CA 94105 PHONE 415 . 398 . 7 5 7 5 DESCRIPTION OF WORK New interior partitions, doors, finishes, ceilings, lighting, electrical, mechanical, and plumbing. EXISTING USE Business Group B PROPOSED USE Business Group B CONSTR. TYPE III NR # STORIES 2 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA 33, 357 NEW FLOORDEMO AREA 33 ' 3, 3 5 7 AREA N/A TOTAL NET AREA 3 3, 3 5 7 BATHROOM N / A KITCHEN OTHER N / A REMODEL N / A REMODEL AREA REMODEL AREA AREA PORCH AREA N/A DECK AREA N/A TOTAI, DECK/PORCH AREA GAN $A A ❑DETACH N/A j ATTACH #DWELLING UNITS N IS A SECOND iT EI OS SAECDO ONT�ORV �N S /A BE NG ADDED PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL # MNO PLANNING APPROVAL LETTER EICHLER HOME? W NO $3,000,000 By my signature below, I certify to each o the following: owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have p vi ed is correc the Description ofWork and verify it is accurate. I agree to comply with all applicable local A�,roperty ordinances and state laws relating to b di g constTO ti e representatives of Cupertino to enter the above-'dentif d property for inspection purposes. f2 Signature of Applicant/Agent: Date: SUPPLEMFNTAItINFORMATItN REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER Tn&covNTER G -TU LDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS �--.-. �� I-��PLMINIPGPLANREVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure TANDARIIllilfzs _ form if any Hazardous Materials are being used as part of this project. ❑ LARGE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR 9 --SANITARY submittal of Building Permit application. SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121/11 CITY OF CUPERTINO P -M7 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 14 results way TYPE OF CONSTR. DATE: 08/13/2012 REVIEWED BY: bobs. APN: BP#: % Z-.0&21 BP FEE ID 'VALUATION: 1$3,000,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: $12,528.34 IBTIINSP hrs PENTAMATION 16 TI I PERMIT TYPE: WORK U. comm offices ace non structural includes M E Ps. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 33,357 $3,528.04 IBTIPLNCK $12,528.34 IBTIINSP hrs $0.00 PME Plan Check: $0.00 Permit Fee: $12,528.34 Suppl. Insp. Fee:(E) Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 TOTALS: 33,357 $3,528.04 $0.00 $12,528.34 MECH, HOURLY 0 Yes (E) No PLUMB, HOURLY Q Yes E) No ` ELEC, HOURLY ® Yes E) No 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 nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 1I-053 Eff 7;1/71) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,528.04 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $12,528.34 Suppl. Insp. Fee:(E) Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select allon-Residential Building or Structure] G Strong, Motion Fee: IBSENWCO $630.00 Select an Administrative Item Bldg .Stds Commission Fee: IBCBSC $120.00 SUBTOTALS: P16,806.38 $0.00 TOTAL FEE; $16,806.38 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: G—k LI) PERMIT # .20 t4 O o l OWNER'S NAME: PHONE # GENERAL CONTRACTOR: X N BUSINESS LICENSE # ADDRESS: yBkc407 CITY/ZIPCODE: p *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 V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork] Cement Finishing Electrical W013 � Excavation Fencing Flooring / Carpeting f 1 Linoleum / Wood Glass/ Glazing el Ll C 0),J � Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper�� Paving Plastering Plumbing +,'Ktj °t -�C - fi t % 1 ►P Roofing Septic Tank Sheet Metal Sheet Rock 5 S 1 Tile ., r Contrador Signature 1:2//14// Date 2010 CALGREEN NON-RESIDENTIAL CHECKLIST — MANDATORY ITEMS I 1= COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION CUPERTINO ALBERT SALVADOR, PS, C,B4O-, BUILDING OFFICIAL 10300 TORRE AVC -NUE - CUKRTINO CA 95014-3255 (ZOO) 777-322a FAX (408) 777-3333 - huild 9ra(LxMertJnrjqrr PURPOSE: The non-residential provisions of the 2010 CalGreen Code outline planning, design and development methods that include environmentally responsible site selection, building design, building siting and development 10 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 air contarninants, Project Name. Project Address, I 7N Project Description: tA I fl"' 17 Instructions: 1. The Owner or the Owner's agent shall employ a licensod 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, hi collaboration with the o-oner and Lhe design professional shall initial Column 2 of this checklist, sign and date Section I - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date SeCUDn 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. General Requirements The project meats all the reqL3r6MWsA9.41visJo.ns 5.1 Planning and Design - Site Development 5.106.1 Storm water pollution prevention plan, For projects of ane acre or less, develop a Storm Water Flolkitfon Prevention Plan (S%rVPPP) that has been designed, specific to its site, conforming to the Stale Storm water NPDES Construction Permit or lo, --al ordinance, whichever is stricter, as is required for projects over one acre- The p'an should cover prevention of soil loss oy storm water run-off andfor wind erosion, of sedimentation and/or of dusto'particullate _111-8-fter af=flu Lic-In- Column 2 Column 3 Project Verification I 1b, rern e nts M rej. rXI 111, I p, 0 1 o �' 9 C.,d(;dv!,?sVon-Res Chec0xr do; twised OSW,11 i 6.106.4 Bicycle parking and changing rooms. Comply with Sections 5 106.4.1 and 5.1013,4.2; or meet local ordinance wN:hever is stricter. 5.106.4.1 Short -Term bicycle parking. If the project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks vAthin 200 feet of the visitors' entrance, readily visible to passers-by, for 5 percent of visitor motorized vehicle parking capacity, with a miromum of one two - bike capacity rack. 6.106.4.2 Long -Term bicycle parking. For buildingswith over 10 tenant - Lai occupants, provide secure bicycle parkirg for 5 percent of tenant -occupied motorized vehicle parking capacity, vAh a minimum of one space. 5.106.5.2 Designated parking. Provide designa�d parking for any combination of low -emitting, fuel-efficient and carpDollvan pool vehicles as Lai shown in Table 5.106.6,2. 6.106.8 Light pollution reduction. Comply with lighting power requirements in the California Energy Gode and desigr:'ntarior and exterior ligiliting such that zero direct -beam illumination leaves the building site, Meet or exceed exterior 171/1 Ull light levels and uniformity ratios for lighting zones I — 4 as defined in Chapter 10 of the California Administrative Godo, using the following slraegies: 1. Shield all exterior luminaires cr use cutoff luminaires, 2. Contain interior lighting within each source. 3, Allow no more than .01 horizontal foot candle 15 tt beycnd the site, LCJ 4. Contain all exterior lighting within property boindaries. El rException: See Part 2, Chapter 12, Section 1205,6 for carnpus. 'ighting requirements for parking facilities and walkways, 5.1 06, 10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings, Construction plans shall indicate how LAJ site grading or a drainage system will manage all surface water flows. Division 5.2 ENERGY EFFICIENCY Performance Requirements 5.201.1 Scope, The California Energy Commission will continue to adopt mandatory building standards. Division 5.3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 6.303.1 Meters. Separate meters shall be installed for the Uses described in Sections 503.1.1 through 503.113. 5.303,11 Buildings In excess of 50,000 square feet. Separate 0 0 submeters shall be installed as follows, 1. For each individual leased, rented or other tenant space within the 1100 building pmjacted tp consume mare than 9allday-_ J'ag;: 2 (J 1* 9 tvvixec? Q8,27;,'i 2. For SPMS used for laundry or cleaners, restaurant or food service. medical or dental office, laboratory or beauty salon or barber shop projected to consume more than 100 gallday, 5,303,1.2 Excess consumption. Any building within a project or space within a building that is projected to consume more than 1.000 galiday, 5.303.2 20 percent savings. A schedule of plumbing fixtures and fixture LQJ fittings that will reduce the overall use of potable water within the building by 20 percent shall be provided, (Calculate savings by Water Use 'Norl(sheets) 6.303.2.1 Multiple showerheads serving one shower. When single shower fixtures are served by more than one shMerthead, the combined flow rate of all the showerheads shall not exceed the maximum flow rates in specified In the 20 percent reduction column contained in Table 5,30323 or he shower steal be designed to only allow one showerhead 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 r17 Lai El 2, Utilizing non -potable water systems. Ica 5.303.6 Plumbing fixtures and fittings. Plumbing (Aures (viater closets and ur'nals) and fittings (faucets and showerl�eads) shall comply with 'he requirements listed for each type in Items listed in Table 5.3016, As applicable 1. Water closets (toilets) — flushometer type nX 2. Water closets (toilets) — tank type ID 3, Urinals 4Public lavatory faucets 5. Public metering self-closing faucets 6. Residential bathroom lavatory sink faucet ID 7. Residential kitchen faucets 8. Residential shower heads 9. Single shower fixtures served by more than one showorhead Outdoor Water Use 5.304.1 Water budget. A water budget shall lie developed for landscape El irrigation use. 5.304.2 Outdoor potable water use. For nevi water service, separate meters or su bnelers shall be installed for indoor and outdoor potable water ase for landscaped areas behveen 1,000 square feet and 5,000 square feet. 5. 304,3 Irrigation design, In new nonresidential projects with between 1,000 As applicable and 9,500 square feet of Landscaped area (the level at which the MLO rn ID applies), install irrigation controllers and sensors which include the following criteria and meet manUtOCtUrer's recommendations. llage 3<,11*9in -Res Checkhst,4.w n.n,iSFd03i27/) I 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that automatically adjust Irrigation In response to changes in plants' needs as F_71 weather conditions change. 2. Weather -based controllers without integral rain sensors or ccimmunicalion systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates rXI with the controller(s). Scil moisture -based controllers are not required to Dave rain sensor input. Weather Resistance and Moisture Management 6.407A Weather protection. Provide a weather -resistant exterior wall and foundation envelope as required by 135fiforr#9 Buddirig Code Section 1403.2 and California Energy Code Section 150, manufactureros installation instructions or local ordinance, whichever is more stringent.' 5.407.2 Moisture control. Employ moisture control measures by the following methods, - 5.407.2.1 Sprinklers. Prevent irrigation spray on structures. L^_J 5.407.2.2 Entries and openings. Design exterior entries and openings to < Z preventwater intrusion into buildings. Construction Waste Reduction, Disposal and Recycling 5.408.1 Construction waste diversion. Establish a construction waste IJ managernent plan or wee -t local ordinance, whichever is more stringent, I ....... . ... . .... 5,408.2 Construction waste management plan. Submit plan per the section to enforcement authonly, 5.408.2.111 Documentation. Provide documentation of the waste management plan that meets the requirements listed in Section 54082 [terns 1 thru 4 and the plan is accessible to the enforcement authority, 5.408.2.2 Isolated Jobsites. The enforcing agency may make ex_-eptons to the requirements of this se --tion when jobsites are located in areas — beyond the haul boundaries of the cllverslaaj�cilit .�� 5.408.3 Construction waste, Recycle andfor savage for rouse a minimum of 50 percent of nonhazardous construction and de'rnolition debris or meet local ordinance, whichever is more stringent. Exceptions: 1. Excavated soil and land -clearing debris. 2. Alternate waste reduction methods developed by working with local agencies if diversion or recycle facilities capable of compliance with this item do nct exist. 5.408.4 Excavated soli and land clearing debris. 100 percent of trees. stumps, rocks and associated vegetation and soils resulting primarily from land FUI 1412) clearing snail be reused or recycled. Ilzige 4 0'9 CedGreeq Xo)i-res CN!rkhstdoe �,Pvhvvd ON271 i Building Maintenance and Operation 5,410.1 Recycling by occupants. Provide readily accessible areas that selNie the entire building and are identified for the depositing, storage and collection of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shail be Included in the design and construction processes of the building project, Commissionirg requirements shall include items listed in Section 5.410.2, 5.410.2.1 Owner's Project Requirements (OPR). Commented riefore the, design phase of the project begins the OPR shall include items listed in 0 Section 5,4110A, 5,410.2,2 Basis of Design (BOO). A written explanatiorl of how the design of the building systems meets the OPIA shall be completed at the design phase of the building project and updated periodically to cover the systems n listed 'n Section 5.4110.2.2. 5.410.2.3 Commissioning plan. A oornmissionirig plan describing how the project will be commissioned shall be started durlrig the design phase of M17 the building project and shail include items listed in Section, 5.410.23. 6.410.2.4 Functional performance testing shall demonstrate the correct installation and operation of each component, system and system -to - UJ system interface In accordance With the approved plans and specifications. 5.410.2.6 Documentation and training, A Systems manual and systems operations training are required. MV 5.410.2,15.1 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 5.41G.2.5.1. 5,410.2.6.2 Systems operations training. The training of Irie appropriate maintenance staff for each equipment type andior system shall Include items listed in Section 5,41 01. 5,2. 6.410.2.6 Commissioning report. A ror'nplete report of commissioning process activities undertaken through the design, construction and reporting recommendations for post-coneruction phases of the building nx project 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, 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems, Systems to be included for testing and adusting shall include, as applicable to the project, the systems listed in Sectior 5-410.3,2. 6.410.4.3 Procedures, Perftwin tesling and adjusting procedures in accordance with industry best practices and applicable national standards K.11 on each system. 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a 1*ldirg or space is operated for normal use, the system should be balanced in accordance with the procedures defined by national standards li5ted in Section 5.410,33.1 P32'. 5 L)f9 (.'WGreeil Ncllr- Res rJ&1??`J I 5.410.4.4 Reporting, After completion of testing, adjusting and balancing, provide a final report of testing signed by he individual responsible for perfouning these services, 0 El 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of guarantiesh,varranties for each, system prior to final inspection. El 5.410.4.5.1 Inspections and reports, Include a copy of all =nspectlon verifications and reports required by the enforcing agency. Fireplaces 5-503,11 Install only a direct -vent sealed -combustion gas or sealed wood - burning fireplace or a sealed woodstove and refer to residential requirements in the Q94forn.'a Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase it emiss-lon limits. Pollutant Control 5,504.3 Covering of duct openings and protection of imechanical equipment during construction. A, the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component openings shall be covered with 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. 5.604.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504A.1 through 5,504,4,4, 5.504.41 Adhesives, sealants, Caulks. Adhesives and sealants used on the project shall meetthe requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, Sealanfs, sealant primers and caulks shall Comply with local or regional air pollution contrcl or air quality rranagernert district rules where applicable or 111,t L61 SCACPAD Rule 1168 VOC limits, as shown in Tables 5,504.4.1 and 5.544.4.2. 2, Aerosol ad hesives and sm a I I er 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 cthe7 requireme.qts, including prohibitions on use of certain toxic compounds, cf California Gode of ReflWations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall comply with Table 5,50-1A,3 unless more stringent local limits apply. MV 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 use of certain toxic compounds and ozone depleting substances (CCR, Title 17. Section 94520 et seq). Page 6 of 9 CalGven Koo-Rcs Chovkfio.tllor -ev(sezt 0&2T I 1 5.504.4.3.2 Verification. Verification of compliance With this section shall be provided at the request of the enforcing agency. 5.604.4.4 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, 5.504.4.44 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 shall meet We requirements of Table 804.4.1 $.$04.4.6 Composite wood products. Hardymod plywood, particleboard and medium denvty fiberboard composite wood products used an the interior or exterior of the building shail meet the requirements for formaldehyde as specified in Table 5.544.4, 5.504.4.6.2 Documentation. Verification of compliance wl,,h this section shall be provided as requested by the enforcing agency. Dacumentation shall include at least one of the following: 'i, Product certifications and specifications 2. Chain of custody certifications 1 Other methods acceptable to the enforcing agency 6.504.4.6 Resilient flooring systems. Comply with the VOC-emission limits defined in the 2009 CHIPS 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. In me&anically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outsAe and return air prior to occupancy that provides at least a?VERV of 8. 6,604.7 Environmental tobacco smoke BETS) control. Prohibit smoking within 25 "eetnf building entries, outdoor air intakes and operable windows where outdoor areas are provided far smoking and in buildings; or as enforced by ordinances, regulations or policies of any city, county, city and CCLsnty, California Community College, campus cf the California State University or CaMPL9 of the University of California, Whichever are more stringent. I Indoor Moisture and Radon Control I 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Budding Coco, CCR, Title 24, Part 2. Sections 1203 and Chapter 14.1. ' Air Quality and Exhaust 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings. meet the minimum requirements of Section 121 of the Cafifornt'a Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 5 or the applicable local code, whichever is more stringent,' fags 7 (A 9 CooGr As applicable El S-71 411 El 0 17-711 I Indoor Moisture and Radon Control I 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Budding Coco, CCR, Title 24, Part 2. Sections 1203 and Chapter 14.1. ' Air Quality and Exhaust 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings. meet the minimum requirements of Section 121 of the Cafifornt'a Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 5 or the applicable local code, whichever is more stringent,' fags 7 (A 9 CooGr 5.506.2 Carbon dioxide (CO2) monitoring, For buildings equipped -Kith demand control ventilation, CO2 sensors and ventilation controls shall be 117771 V%j specified and installed in accordance with the requirernews of the latest edition of the Callorn?a Energy Code, CCR, Title 24, Part 6, Section 121(c),' Environmental Comfort 6,507.4 Acoustical control. Employ building assemblies and components kaj with STC values determined in accordance With ASTM E 90 and ASTM E 413, 5.607.4.1 Exterior noise transmission. Wall and floor-ceiling assemblies making up the building envelope shall have on STC of at least 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 5,507.5,11, 6.507.4,2 Interior sound. Wall and floor-ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of M-1 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 5.508.1.1 and 5.508.1.2. As applicabte 6.508.1.1 CFCs. Install HVAC and refrigeration equipment that does not M-1 In) IJ contain CFCs.' 5.508.1.2 Halons. Install fire suppression equipment that does not contain Halons," I 1. These measures are currently required elsewhere in statute or in regul.plior. NVC 8 ON (7u,"Grom XwO4,s revis&l I Project Name: Project Address: Project Oescription: CALGREEN SIGNATURE DECLARATIORS cit SECTION 'I - DESIGN VERIFICATION Completer all Hnes of Section i —'Design Verif atice and submit the completed checklist (Colmns 1 and 2) with the plans and building permit applicalion to the Building Depariment. The owner and design professional responsible for compliance with CalGreen Slandards have revised the plans and certify that the Items checked move are hereby incorporated Into the project plans and wig be imptemenled into the prefect 1st accordance with the regCrernents set forth In the 2010 California Green Building Standards Code as adopted y the City of Cupertino, t owrvsr' stare .?4 Date Own a res0print) Desfjrr�re nnars Signaiure Data Design lard as al's Name (Presse P nt) SIgnsfur,kofUcense Professiorrai r4ponsibte for 040reen complla;roe ©ate ,� OB Z4 Name of LIcense Professional responsible for CalGreen compliance (Please Print) PIrne M.% yr 6 C01 Ai E% x.NC ': - 'c 0 Einall Address for License Professional responsible for CatGreen compliance SECTION 2- IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, Imiuding column 3, toc.etherwith all original signatures on Se.~tian 2 to Vie Building Department pilorto Building Drrpartraent rireat Inspection, have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed In accordance vAth this Green Building Checkllstend In accordance with the regvirements of the 2010 California Green Boilding Standards Code as adapted by the City of Cupe�rlino_ Signature cf l ieense professional ms,po ns ib la for CalGreen coaoplia r* Date] Name of license Professlonar responsible forCalGreern compliafnce (Please MI) Phone Pngc 9 of 9 ColGie w lebor•Res Checkirst.doc reid5eJO&I1r11