12120065CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10160 HILLCREST RD
CONTRACTOR: CRAFTSMENS GUILD INC
PERMIT NO: 12120065
OWNER'S NAME: STEPHEN J GROSS
10566 S DE ANZA BLVD
DATE ISSUED: 04/04/2013
OWNER'S PHONE: 4083431115
CUPERTINO, CA 95014
PHONE NO: (408)366-1000
❑ LICENSED CONTRACTOR'S DECLARATION
r r f—
BUILDING PERMIT INFO:
0
BLDG ELECT PLUMB
License Class_ Lic.# I
�.
r r
MECH RESIDENTIAL COMMERCIAL
Contractor Dat 10/
fW
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: CONSTRUCT 654 SQ FT SECOND STORY ADDITION; 730 SQ
(commencing with Section 7000 of 3 of Business Professions
( gi)f Dif thBi&Pfi
FT FIRST STORY GARAGE ADDITION; 544 SQ FT SECOND
STORY REMODEL AND 99 SQ FT BATHROOM REMODEL. 6/17/13-REV#1 - REVISE MASTER BATHROOM
Code and that my license is in full force and effect.
LAYOUT WITH NEW WINDOW LOCATIONS; REVISE 2ND STORY BALCONY LAYOUT AND DOOR
CONFIGURATION-ISSD OTC 6/17/13 REV#1
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.
��"���
REVV
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
Sq. Ft Floor Area:
Valuation: $160000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 32616071.00
Occupancy Type:
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,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point so regul ons per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date` ��]]
� /
y•
Issued b 3
! Y /7%� Date: �O `//7'/
❑ OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
RE-ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec. 7044,
inspection.
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
1 certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, I
Health & Safety Code, Sections 25505, 25533, and 25534.
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.
Owner o thoriz agent: Dat/i ...7 %
Date: L, / 1 / / �t7
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
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.
ARCHITECT'S DECLARATION
I Understand my plans shall be used as public records.
Signature Date
Licensed Professional
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CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Punuc works, tire, aanuury Jewer L[au[uq �u[uu[
TL--- .r -- . - L_-1 __ .t— ava;lahle and are only an estimate. Contact the Dept for addn'l info.
/J[J[r[ut, e[(:. . I [[cJG cW u[c ouocu — a.w ..-........».
FEE ITEMS (Fee Resolution 11-653 Ef: 7i1 1;,12)
ADDRESS: 10160 Hillcrest Rd
DATE: 06/17/2013
REVIEWED BY: Sean
y —
APN:
BP#: 12120065
`VALUATION: Iso
xPERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY
SFD or Duplex
0.0 1
PENTAMATION 1GENRES
PERMIT TYPE:
USE:
PME Plan Check:
$0.00
WORK
Revision #1: Revise master bathroom layout with new window locations; revise 2nd story balcony
SCOPE
layout and door configuration.
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Punuc works, tire, aanuury Jewer L[au[uq �u[uu[
TL--- .r -- . - L_-1 __ .t— ava;lahle and are only an estimate. Contact the Dept for addn'l info.
/J[J[r[ut, e[(:. . I [[cJG cW u[c ouocu — a.w ..-........».
FEE ITEMS (Fee Resolution 11-653 Ef: 7i1 1;,12)
Wech. Plan Check
Plumb. Plan Check
iec. flan Check
y —
Plumb. Permit Ree:
ElecPermit I ee:
Other tllech. Inst-
Other Plumb Insp.
Other Floc, Insp.
Suppl. PC Fee: 0 Reg. Q OT
0.0 1
hrs
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Punuc works, tire, aanuury Jewer L[au[uq �u[uu[
TL--- .r -- . - L_-1 __ .t— ava;lahle and are only an estimate. Contact the Dept for addn'l info.
/J[J[r[ut, e[(:. . I [[cJG cW u[c ouocu — a.w ..-........».
FEE ITEMS (Fee Resolution 11-653 Ef: 7i1 1;,12)
... ... .._�__..._ -. �'_�_--
FEE
------ --- -
QTY/FEE
-
MISC ITEMS
Plan Check Fee: Hourly Only? Yes Q No
$0.00
F___27 hours Plan Check, Hourly
$266.00 ISTPLNCK
Suppl. PC Fee: 0 Reg. Q OT
0.0 1
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. Q OT
F0.0Thrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
Administrative .Fee:
0
Work Without Permit? Q Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
I
E)
/
71 -al cl
Strong Motion Fee:
$0.00
Select an Administrative Item
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
1 $0.00
$266.00
TOTAL FEE:
$266.00
Revised: 04/29/2013
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
&a ---
ADDRESS: 10160 Hollcrest Road
DATE: 01/10/2013
REVIEWED BY: Sean
jM
APN:
BP#: 12120065
*VALUATION: 1$160,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Yes ; No
OTC. ® Yes (j) No
PENTAMATION 1 R3SFDADD
PERMIT TYPE:
WORK
CONSTRUCT 654 SQ FT SECOND STORY ADDITION; 730 SQ FT FIRST STORY GARAGE
SCOPE I
ADDITION; 544 SQ FT SECOND STORY REMODEL AND 99 SQ FT BATHROOM REMODEL.
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
(s.L)
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
1,384
$2,544.72
1R3PLNCK
$1,823.92
1R31NSP
PME Plan Check:
$0.00
=s.f.
$600.00
Remodel, Bath (<=300 sf)
1REMRESBAT
Permit Fee:
$1,823.92
Suppl. Insp. Fee:) Reg. Q OT0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
1,384
$2,544.72
$1,823.92
ME
ECH, HOURLY 0 Yes (j) No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY Q Yes Q No
MISC ITEMS
Plan Check Fee:
tkICC:Y1 !r Fee:
st2t±?II:. ls(:.✓!7i- ....
I:iC'C -
Other ;tteer,, fn, .
`t mj) 111sp,.
tr.'i:', In:l1:.
El
'�•L� [-..
Fee.
PME Plan Check:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,544.72
544 s.f.
$467.00
Remodel, Other
IREMRESOTH
Suppl. PC Fee: F) Reg. Q OT0.0
hrs
$0.00
PME Plan Check:
$0.00
=s.f.
$600.00
Remodel, Bath (<=300 sf)
1REMRESBAT
Permit Fee:
$1,823.92
Suppl. Insp. Fee:) Reg. Q OT0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
F,.L3Ss'4ii'(i£.i i£i�b t C?✓`c.
'h biiinistra ive I"e'£:':
G
Work Without Permit? Yes ) No
$0.00
Advanced Planning Fee: IPLLONGR
$179.92
Select a Non -Residential
Building or Structure
G
Strong Motion Fee: 1BSEISMICR
$16.00
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$7.00
SUBTOTALS:
$4,571.56
$1,067.00
TOTAL FEE:
T $5,638.56
Revised: 10/01/2012
CUPERTINO
CONSTRUCTION PERMIT APPLIC I
COMMUNITY DEVELOPMENT DEPARTMENT- BUILDINM11®N---.•�....,•
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org
❑ NEW CONSTRUCTION [Z ADDITION ❑ ALTERATION / TI *REVISION /DEFERRED ORIGINAL PERMIT tl
I� r
_rl
PROJECT ADDRESS 10160 1 �`-'S
APN #
6 -671
OWNER NAME
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PHONE � tZ 1 — •i � E-MAIL S �`Jj yp SS
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STREET ADDRESS /O / P /�
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STREET ADDRESS f Of �(� e �
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 14 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME '/ S S ��j� `n�
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LICENSE NUMBER S'07 J �/
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LICENSE TYPE
BUS. LIC #
COMPANY NAMEC..�-^ T S ML_� J,''{ C,
EMAIL Nk(,
FAX
STREET ADDRESS/O 5 / jam, Q ►'j1 Yr
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ARCHITECT/ENGINEERNAME M p'1 r�/`��/" j�,T
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BUS, LIC
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONF� < 7,,r
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/
DESCRIPTION OF WORK u ( V-, C",�A� C
EXISTIN SE
PROPOSE "SE CONSTR.
TYPE
# STO S
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR DEMO
TOTAL
AREA
AREA AREA
NET AREA
BATHROOM KITCHEN
OTHER
REMODEL AREA REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECKIPORCH AREA
I GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS :
IS A SECOND UNIT [3 YES
SECONDSTORY ❑YES
BEING ADDED? ❑NO
ADDITION? []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLERHOME? ❑NO
RECEIVE BY:
r f
TOTAL V TION:
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 co ct. 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 build' g cons tr tion. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. .
Signature of Applicant/Agenv — Date:
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TN PE
ROI "PING SLIP
OVER-THEcouNTrli
BGILDINc PLAN REVIEW
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS.
t-,!dt, PLANNING PLAN RE�IEw
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
EJSTANDARD
❑ PUBLIC WORKS
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 to
❑ DIAJOR
❑ SANITARY SLwER DISTRICT
submittal of Building Permit application.
_
❑ ENF'IRON111GN"I'AL HEAL -CH
B1dgApp_2011.doc revised 06/21/11
CUPERTINO
F-1 NFW ('()NSTRI I('TTnN
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)77777-3228 • FAX (408) 777-3333 • buildin4(a1cupertino.org
1 VI)71IT)ITION 1 I Ai TFR ATION / Ti IinI RFVISICIN / nFFFRRFi)
ORIC;INAL PFRMIT #
6 —
PROJECT ADDRESS 16110
Q P )CLC GV' 1 f-fAPN # 3 Z6—
CC77 ,e E 7-- R �' r`�
OWNERNAMEM f /•f Gleor(
�0
PHONN,-;, I' I
E-MAIL
STREET ADDRESS to�/ �� ^ nEr T •
/0' (! lIq
CITY, STATE, ZIP /7 u p� �r T I N 0 CA •
(�
FAX
CONTACT NAME M II (•(✓ / A I Al ('
PHONE (.4 6 J \ _ 9i (,
E-MAIL M (l�£ # C1 O,4Fr(� E -A.-5 G
STREET ADDRESS l0 L /t�j • , t)r, A A17A -5 Ly CITY, STATE, ZIP o open ie -r ( /t/ o
• _ !/u
FAX � _,366 1 I
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR I7 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 11 TENANT
CONTRACTOR NAME % D y4FT( M G` N ( C IP W 14
LICENSE NUMBERSQ 7 l f9
LICENSE TYPE ��
BUS. LIC #
COMPANY NAME GI?ii#.FrS1�t(_ISJ�(1It-D ily
E-MAILMkKtCMVje� /MG 5tyUt
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STREETADDRESS N�,4• -FLV `
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CITY, STATE, ZIP 6U P6 eT IN o C� '
PHONE �Q � Q= '_, (6 Q
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ARCHTECT/ENGINEER NAME � GI I I U5
LICENSE NUMBER r 0 , f
BUS. LIC # fob �y9
COMPANY NAME Cp T: 1 M,F I✓ �(� �-h tJ
E-MAIL M t (t C Coe 74 r1 1 g t V S 60,,
nFAX
STREET ADDRESS/b `66 • �� NZ� DW
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CITY, STATE, ZIP C+ ET U f'Q0 C-
PHONE
DESCRIPTION OF WORK
i5fJL_,4Q r�f� G A&Qtoe"W,4&, t�µt" '%��• �V'�A1
l V
d 40' 2 C04. t,�. T w -
EXISTING USE ,
, 35
PROPOSED USE CONSTR.
f C �
YPE
# STORIES
�
USE
TYPE
OCC.
SQ�.F^T.
VALUATION ($)
+J`t'y'•
EAREAG f7
AREA L/DOOREMO
3 Z
TOTAL`�
NET AREATi
IC�.7�1�
�E�
i
,"/
r o dod
'
BATHROOM
REMODEL AREA C7 /_ a
KITCHEN
REMODEL AREA a
OTHER
REMODEL AREA ( Q
o 1 _ I
�r
��
2- (� / ih
Cl
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DE CH
# DWELLING UNITS:
IS A SECOND UNIT❑
SECOND STORY S
BEING ADDED? L. O
ADDITION? QNO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PL.ANNTNG APPL # []NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLER HOME? n4e_
,.
RECEIVED BY5.
TOT7 QT}O_.L_
U/
/
/
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 c truction. I orize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTALlN`FOlWrRE0TJlRED
PLANCHECKTYPE
ROUTING SLIP:
❑ OVER-THE-COUNTER
17 BUILDINIc PLAN REVIEW
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS
�----
v PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
Q -STANDARD
❑ PUBLICWORKS
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 to
❑ MAJOR
LJ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp 2011.doc revised 06/21/11
fl���� CITY OF CUPERTINO
o, FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10160 hillcrest rd.
DATE:
REVIEWED BY: bobs.
PC FEE ID
APN:
BP#:
VALUATION: 1$160,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex
USE:
2nd Unit? 0 Yes No
OTC. 0 Yes (F) N0
PENTAMATION 1 R3SFDADD
PERMIT TYPE:
WORK
sfd add 654 s.f. to master bedroom remodel 260 s.f. existing family bathroom.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
sJ.
aa�<h. !"'an C'rlE:ck
PC FEE ID
BP FEES
BP FEE ID
R-3 (Custom)
II-B,111-B,IV,V-B
654
$2,468.00
3PLNCK
$1,549.00
IR3INSP
...' . Lisp kcc'
$0.00
Permit Fee:
$1,549.00
Suppl. Insp. Fee:Q Reg. 0 OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
654
$2,468.00
$1,549.00
MECH, HOURLY 0 Yes G No
PLUMB, HOURLY 0 Yes 0 No
ELEC, HOURLY 0 Yes Q No
aa�<h. !"'an C'rlE:ck
Plumb. flan Check FT
Elec. Plan Check
$2,468.00
260 s.f.
$600.00
F.1ec. Permit F ..
Other Tech. Insp.
Other 1'lrrm(i insp.
01hei• Elec. Insp. Li
J� ?nsp, f ee.
$0.00
...' . Lisp kcc'
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 oreliminary information available and are onlv an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Ef. 7i1 1/12)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,468.00
260 s.f.
$600.00
Remodel, Bath (<=300 sf)
IREMRESBAT
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,549.00
Suppl. Insp. Fee:Q Reg. 0 OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
,ldrninistrative Feer:
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee: 1PLLONGR
$85.02
Select a Non -Residential
Building or Structure
I
O
0
i
Travel Documentation Fees:
Strong Motion Fee: 1BSEISMICR
$16.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$7.00
SUBTOTALS:
$4,125.02
$600.00
TOTAL FEE:
E
$4,725.0mmj2
Revised: 10/01/2012
OVA
/V I ly) It/b/-
to
t/to
Q X
o0 Z/�/
Ir. / "4�4w�d "/Q-tlqe _yiz -�/
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10160 HILLCREST RD
CONTRACTOR: CRAFTSMENS GUILD
PERMIT NO: 12120065
INC
OWNER'S NAME: STEPHEN J GROSS
10566 S DE ANZA BLVD
DATE ISSUED: 04/04/2013
OWNER'S PHONE: 4083431115
CUPERTINO, CA 95014 a.PHONE
NO: (408)366-1000
13LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
�/ #
CONSTRUCT 654 SQ FT SECOND STORY ADDITION; 730
License Class Lic.
Contractor C,PA�i1 M4CW GUl�' Date O 3
SQ
FT FIRST STORY GARAGE ADDITION; 544 SQ FT SECOND
I hereby affirm that I am licensed under the provisions of Chapter 9
STORY REMODEL AND 99 SQ FT BATHROOM REMODEL.
(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.
Sq. Ft Floor Area:
Valuation: $160000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 32616071.00
Occupancy Type:
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
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITBIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DA CALLED INSPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
/41
costs, and expenses which may accrue against said City in consequence of the
Date: V
granting of this permit. Additionally, the applicant understands and will comply
"11 V!
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
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6:95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(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
Owner or authorized agent: Date:4"13
permit is issued.
F
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
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
� �
n� � �
;�
G'G�
� � � ,�
� ��
� -� S�ii � �9 �Q � �
�'/�/�
C001
l?kst Ualle Ow or ists
Urban Tree Specialist
I.S.A CERTIFIED ARBORIST WE -7505A
Licensed - Bonded - Insured
April 3, 2013
Re: Arborist Report
Property: 10160 Hillcrest Road
Cupertino, CA. 95014
To Whom It May Concern:
On April 1, 2013, a site visit was made to 10160 Hillcrest Road, Cupertino, CA. 95014 to
evaluate the issues surrounding the ability of the existing perimeter trees to produce adequate
privacy screening for proposed construction.
Tree # 1 is a native California pepper with a height of 20', a crown spread of 20' and a
circumference of 50". The health is viewed as good. The foliage is normal in terms of size,
coloration and distribution.
Tree #2, a Coastal Live Oak with a height of 25', a crown spread of 25' and a circumference of
58" is also viewed in good health with normal foliage and live crown ratio.
In between trees #1 and 2 are a series of purposed planted Privet trees now at a height of
approximately 12'. These are a very aggressive and fast growing genus (ligustrum) and should
provide adequate screening within months if not at present. The "secret" to maintaining a privet
screen is to cut them at a certain height once the foliage becomes too high to provide lower
screening effects. This "topping" will provide profuse sucker growth at the desired height by
careful choice of cut placement.
Please feel free to contact our office contact us if you have any questions or concerns.
Sincerely,
J
Simon J. Tunnicliffe, Owner Operator
ISA Certified Arborist WE -7505A
PO Box 162 • Campbell, CA 95009 -408-866-1148 - CSL#892956
For All Your Arboricultural Needs
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:
SUBCONTRACTOR
BUSINESS NAME
PERMIT # 12-1 Z00
OWNER'S NAME: j rAtV55PHONE
Cabinets & Millwork
#
GENERAL CONTRACTOR:CfitPbrn
BUSINESS LICENSE #
ADDRESS:
`
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 Date
Please check applicable subcontractors and complete the following information:
4�4
Owner / Contracto Signature
3/tt11s
Date
9
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
r x" -h `
24311
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
3 0
Landscaping
Lathing
SO)QrA 1>L AFSTr)2/
34962-
3496ZMasonry
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Z Cl Soo
Roofingj
�e rtG
2 0195 A.
Septic Tank
Sheet Metal
Sheet Rock
Tile
4�4
Owner / Contracto Signature
3/tt11s
Date
9
BUILDING ENERGY ANALYSIS REPORT
PROJECT:
Gross Residence
10160 Hillcrest Road
Cupertino, CA 95014,,
l:-
Project Designer:';::.
CUPERTINO
Building Department
APR 0 3 2013
Craftsmen's Guild IncEVIEWED FOR CODE COMPLIANCE
10566 South De Anza BlvdReviewed By
Cupertino , CA 95014
(408) 366-1000
Report Prepared by: OFFICE COPN
Miles Hancock
Energy Design Group
2149 Dartmouth Street
Palo Alto, CA 94306
(650) 424-1189
Job Number:
CG4133EA
Date:
2/25/2013
IT TA
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: 5900 RunCode: 2013-02-25T21:13:04 ID. CG4133EA
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
EnergyPro 5.1 by EnergySoft Job Number. ID: CG4133EA User Number. 5900
1
2
3
10
13
PERFORMANCE CERTIFICATE: Residential Part 1 of 5
CF -1 R
Project Name
Gross Residence
Building Type m Single Family ❑ Addition Alone
❑ Multi Family m Existing+ Addition/Alteration
Date
2125/2013
Project Address
10160 Hillcrest Road Cupertino
California Energy Climate Zone
CA Climate Zone 04
Total Cond. Floor Area
4,133
Addition
674
# of Stories
2
FIELD INSPECTION ENERGY CHECKLIST
❑ Yes ❑ 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
Construction Type
Area Special
Cavity (ft) Features (see Part 2 of 5) Status
Floor Wood Framed w/Crawl Space
None 3,223 Existing
Wall Wood Framed
R-11 2,486 Existing
Door Opaque Door
None 58 Existing
Roof Wood Framed Attic
R-19 3,364 Existing
Slab Unheated Slab -on -Grade
None 76 Perim = 12' Existing
Floor Wood Framed w/o Crawl Space
R-19 674 New
Wall Wood Framed
R-13 631 New
Roof Wood Framed Attic
R-30 674 New
FENESTRATION U-
Orientation Area(ft) Factor
Exterior
SHGC Overhang Sidefins Shades Status
Front (W) 104.8 0.550
0.67 none none Bug Screen Existing
Rear (E) 100.0 0.550
0.67 none none Bug Screen Existing
Right (S) 80.0 0.550
0.67 none none Bug Screen Existing
Rear (NE) 59.0 0.550
0.67 none none Bug Screen Existing
Front (M 34.7 0.400
0.35 none none Bug Screen Altered
Front (lAq 12.8 0.400
0.35 none none Bug Screen New
Rear (E) 37.5 0.400
0.35 none none Bug Screen Altered
Rear (E) 35.0 0.550
0.67 none none Bug Screen Removed
Right (S) 44.0 0.400
0.35 none none Bug Screen New
Left (N) 52.5 0.550
0.67 none none Bug Screen Removed
Left (N) 10.8 0.400
0.35 none none Bug Screen New
HVAC SYSTEMS
Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status
1 Central Furnace 78% AFUE No Cooling 13.0 SEER Setback
Existing
HVAC DISTRIBUTION
Location Heating
Duct
Cooling Duct Location R -Value Status
HVAC System Ducted
Ducted Attic, Ceiling Ins, vented 2.1
Existing
WATER HEATING
Qty. Type Gallons Min. Eff Distribution Status
Ener Pro 5.1 by EnergySoft User Number: 5900 RunCode: 2013-02-25T21:13:04 ID: CG4133EA
Page 3 of 13
PERFORMANCE CERTIFICATE: Residential Part 1 of 5
CF -1 R
Project Name
Gross Residence
Building Type m Single Family ❑ Addition Alone
❑ Multi Family ® Existing+ Addition/Alteration
Date
2125/2013
Project Address
10160 Hillcrest Road Cupertino
California Energy Climate Zone
CA Climate Zone 04
Total Cond. Floor Area
4,133
Addition
674
# of Stories
2
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.
IZI Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details.
INSULATION Area Special
Construction Type Cavity (ft) Features (see Part 2 of 5) Status
FENESTRATION U- Exterior
Orientation Area(ft) Factor SHGC Overhang Sidefins Shades Status
Rear (E) 50.0 0.400 0.35 none none Bug Screen New
Left (NE) 24.0 0.400 0.35 none none Bug Screen New
HVAC SYSTEMS
Ot . Heating Min. Eff Cooling Min. Eff Thermostat Status
HVAC DISTRIBUTION Duct
Location Heating Cooling Duct Location R -Value Status
WATER HEATING
Qty- Type Gallons Min. Eff Distribution Status
EnergyPro 5.1 by EnergySoft User Number: 5900 RunCode: 2013-02-25T21:13:04 ID: CG4133EA
Page 4 of 13
PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF -1 R
Project Name
Gross Residence
Building Type m Single Family 0 Addition Alone
❑ Multi Family m Existing+ Addition/Alteration
Date
2125/2013
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 HVAC System Fumace - A/C does not include a cooling system, field verification is not necessary.
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.
Ener Pro 5.1 by EnergySoft User Number: 5900 RunCode: 2013-02-25721:13:04 ID: CG4133EA Page 5 of 13
PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1 R
Project Name
Building Type m Single Family ❑ Addition Alone
Date
Gross Residence
❑ Multi Family m Existing+ Addition/Alteration
1212512013
ANNUAL ENERGY USE SUMMARY
Standard Proposed Margin
TDV kBtu/ft2- r
Space Heating 42.42 40.64 1.78
Space Cooling 18.20 14.47 3.73
Fans 9.56 8.43 1.14
Domestic Hot Water 10.56 10.56 0.00
Pumps 0.00 0.00 0.00
Totals 80.74 74.09 6.65
Percent Better Than Standard: 8.2%
BUILDING COMPLIES - NO HERS VERIFICATION REQUIRED
Fenestration
Building Front Orientation: W 265 deg Ext. Walls/Roof Wall Area Area
Number of Dwelling Units: 1.00 (l9 900 152
Fuel Available at Site: Natural Gas (N) 921 35
Raised Floor Area: 3,897 (E) 952 247
Slab on Grade Area: 76 (S) 960 124
Average Ceiling Height: 9.3 Roof 4,038 0
Fenestration Average U-Factor: 0.49 TOTAL: 558
Average SHGC: 0.55 Fenestration/CFA Ratio: 13.5%
REMARKS
The information in this report is for permit documentation purposes only. Energy Design Group makes no guarantee regarding the comfort or
performance of the building in this report. The contractor shall independently verify proper HVAC system sizing.
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 Energy Design Group ;
2252013
Address 2149 Dartmouth Street Name Miles Hancock }%
City/State/ZipCity/State/Zip Palo Alto, CA 94306 Phone (650) 424-1189 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 Craftsmen's Guild Inc.
Address 10566 South De Anza Blvd. Name
City/State/Zip Cupertino, CA 95014 Phone (408) 366-1000 Signed License # Date
EnerqyPro 5.1 by EnergySoft User Number: 5900 RunCode: 2013-02-25721:13:04 ID: CG4133EA Page 6 of 13
CERTIFICATE OF COMPLIANCE:
Residential
(Part 4 of 5) CF -1 R
Project Name
Gross Residence
Building Type 0 Single Family ❑ Addition Alone
❑ Multi Family m Existing+ Addition/Alteration
Date
2125/2013
OPAQUE SURFACE DETAILS
Surface
Type Area
U- Insulation Joint Appendix
Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
Floor
2,513
0.097 None
0
180 Existing 4.4.1-A1
Main Floor
Wall
466
0.110 R-11
265
90 Existin 4.3.1-A2
Main Floor
Door
25
0.500 None
265
90 Existin 4.5.1-A4
Main Floor
Wall
503
0.110 R-11
355
90 Existing 4.3.1-A2
Main Floor
Door
17
0.500 None
355
90 Existing 4.5.1-A4
Main Floor
Wall
306
0.110 R-11
85
90 Existing 4.3.1-A2
Main Floor
Door
17
0.500 None
85
90 Existing 4.5.1-A4
Main Floor
Wall
478
0.110 R-11
175
90 Existing 4.3.1-A2
Main Floor
Roof
2,494
0.049 R-19
0
0 Existing 4.2.1-A4
Main Floor
Slab
76
0.730 None
0
180 Existing 4.4.7-A 1
Main Floor
Wall
109
0.110 R-11
55
90 Existing 4.3.1-A2
Main Floor
Wall
93
0.110 R-11
115
90 Existing 4.3.1-A2
Main Floor
Floor
710
0.097 None
0
180 Existing 4.4.1-A1
UpPerFloor
Wall
128
0.110 R-11
265
90 Existing 4.3.1-A2
Upper Floor
Wall
84
0.110 R-11
85
90 Existing 4.3.1-A2
Upper Floor
Wall
320
0.110 R-11
175
90 Existing 4.3.1-A2
Upper Floor
FENESTRATION SURFACE DETAILS
ID
Type
Area U -Factor
SHGC
Azm Status
Glazing Type
Location/Comments
1
Window
104.8 0.550 Default
0.67 1 Default
265 Existing
Double Non Metal Clear
Main Floor
2
Window
92.0 0.550 Default
0.67 Default
85 Existing
Double Non Metal Clear
Main Floor
3
Window
80.0 0.550 Default
0.67 Default
175 Existing
Double Non Metal Clear
Main Floor
4
Window
59.0 0.550 Default
0.67 Default
55 Existing
Double Non Metal Clear
Main Floor
5
Window
34.7 0.400 NFRC
0.35 NFRC
265 Altered
Double Non Metal
Upper Floor
6
Existing
0.550 Default
0.67 Default
Double Non Metal Clear
pre -altered for above
7
Window
12.8 0.400 NFRC
0.35 NFRC
265 New
Double Non Metal
Upper Floor
8
Window
37.5 0.400 NFRC
0.35 NFRC
85 Altered
Double Non Metal
Upper Floor
9
Existing
0.550 Default
0.67 Default
Double Non Metal Clear
pre -altered for above
10
Window
8.0 0.550 Default
0.67 Default
85 Existing
Double Non Metal Clear
Upper Floor
11
Window
35.0 0.550 Default
0.67 Default
85 Removed
Double Non Metal Clear
Upper Floor
12
Window
4.0 0.400 NFRC
0.35 NFRC
175 New
Double Non Metal
Upper Floor
13
Window
52.51 0.550 Default
0.67 Default
355 Removed
Double Non Metal Clear
Upper Floor
14Window
1
10.81 0.400 NFRC
0.35 NFRC
355 New
Double Non Metal
Upper Floor Addition
15
JWYndow 1
50.01 0.400 NFRC
0.35 NFRC
85 New
Double Non Metal
Upper Floor Addition
16
Window 1
40.01 0.4001 NFRC
0.35 NFRC
175 New
Double Non Metal
Upper Floor Addition
(1) Ll-FactorType: 116-A =Default Table from Standards, NFRC =Labeled Value
2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
ID
Exterior Shade Type SHGC
Window
H t Wd
Ove hang Left Fin Right Fin
Len H t LExt RExt Dist Len Hat Dist Len Hat
1
Bug Screen
0.76
2
Bug Screen
0.76
3
Bug Screen
0.76
4
Bug Screen
0.76
5
Bug Screen
0.76
6
Bug Screen
0.76
7
Bug Screen
0.76
8
Bug Screen
0.76
9
Bug Screen
0.76
10
JBug Screen
0.76
11
Bug Screen
0.76
12
Bug Screen
0.76
13
Bug Screen
0.76
14
Bug Screen
0.76
15
Bug Screen
0.76
16
Bug Screen
0.76
EnergyPro
5.1 by Ener Soft User Number.- 5900 RunCode: 2013-02-25T21:13:04 ID: CG4133EA
Page 7 of 13
CERTIFICATE OF COMPLIANCE: Residential
(Part 4 of 5) CF -1 R
Project Name
Gross Residence
Building Type m Single Family
❑ Multi Family
❑ Addition Alone
m Existing+ Addition/Alteration
Date
1212512013
OPAQUE SURFACE DETAILS
Surface U- Insulation
Type Area Factor Cavitv Exterior Frame Interior Frame Azm Tilt Status
Joint Appendix
1 4
Location/Comments
Roof 870 0.049 R-19
0 0 Existing
14.2.1-A4
Upper Floor
Wall 278 0.110 R-11
35590 Removea 4.3.1-A2
U.0 -per Floor
Wall 46 0.110 R-11
85 90 Removec 4.3.1-A2
Upper Floor
Floor 674 0.048 R-19
01 180 New
4.4.2-A4
Upper Floor Addition
Wall 101 0.102 R-13
265 90 New
4.3.1-A3
Upper Floor Addition
Wall 338 0.102 R-13
355 90 New
4.3.1-A3
Upper Floor Addition
Wall 97 0.102 R-13
85 90 New
4.3.1-A3
U per Floor Addition
Wall 38 0.102 R-13
175 90 New
4.3.1-A3
Upper Floor Addition
Roof 674 0.032 R-30
0 0 New
4.2.1-A8
Upper Floor Addition
Wall 29 0.102 R-13
295 90 New
4.3.1-A3
Upper Floor Addition
Wall 28 0.102 R-13
25 90 New
4.3.1-A3
Upper Floor Addition
FENESTRATION SURFACE DETAILS
ID Type Area U -Factor SHGC
Azm Status Glazing Type
Location/Comments
17 Window 24.0 0.400 NFRC 0.35 NFRC 25 New Double Non Metal Upper Floor Addition
(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
Len H t LExt RExt
Left Fin
Dist Len H t
Right Fin
Dist Len H t
17 Bug Screen 0.76
Ener Pro 5.1 by EnergySoft User Number., 5900
RunCode: 2013-02-25T21:13:04
ID: CG4133EA
Page 8 of 13
CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -1 R
Project Name
Gross Residence
Building Type ❑ Single Family ❑ Addition Alone
❑ Multi Family m Existing+ Addition/Alteration
Date
2125/2013
BUILDING ZONE INFORMATION
System Name Zone Name
Floor Area
New Existing Altered Removed Volume Year Built
HVAC System Main Floor
2,589
25,890 1984
Upper Floor
870
6,960 1984
Upper Floor Addition
674
5,392
Totals 1 6741 2,5891 8701 0
HVAC SYSTEMS
System Name Qty. Heating Type
Min. Eff. Cooling T pe Min. Eff. Thermostat Type Status
HVAC System 1 Central Furnace
78% AFUE No Cooling 13.0 SEER Setback
Existing
HVAC DISTRIBUTION
System Name Heating
Duct
Cooling Duct Location R -Value
Ducts
Tested? Status
HVAC System Ducted Ducted Attic, Ceiling Ins, vented 2.1
❑ Existing
WATER HEATING SYSTEMS
S stem Name
Qty-
Type
Distribution
Rated
Input
Btuh
Tank
Cap.
al
Energy
Factor
or RE
Standby
Loss or
Pilot
Ext.
Tank
Insul. R-
Value
Status
Standard Gas 75 gal or Le
1
Small Gas
No Pipe Insulation
70,000
75
0.53
n/a
n/a
Existing
MULTI -FAMILY WATER
HEATING
DETAILS
HYDRONIC
HEATING SYSTEM
PIPING
Control
Hot Water Piping Length
0
m
0
Q
System Name
Pipe
Length
Pipe
Diameter
Insul.
Thick.
Qty- FHP
Plenum Outside Buried
I El
EnergyPro 5.1 by Ener Soft User Number: 5900
RunCode: 2013-02-25T21:13:04 ID: CG4133EA
Page 9 of 13
MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R
Project Name
Gross Residence
Date
2/25/2013
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)l: 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(1): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(1) when the
installation of a Cool Roof is specified on the CF -1 R Form.
*§1 50 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.
*§1 50 c : Minimum R-13 insulation in wood -frame wall orequivalent U -factor.
*§1 50 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).
§150(j)1A: 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.
§150(j)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.
§150(j)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-B.
§150(j)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.
§150(j)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table
123-A.
150(j)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.
EnergyPro 5.1 by EnergySoft User Number: 5900 RunCode: 2013-02-25T21:13:04 ID: CG4133EA Page 10 of 13
MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R
Project Name
Date
Gross Residence
2/25/2013
§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 tape 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 tape 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. 5900 RunCode: 2013-02-25721:13:04 ID: CG4133EA Page 11 of 13
MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R
Project Name
Date
Gross Residence
2/25/2013
§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)12: 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)13: 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 Exceptions 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)14: 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)16: 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: 5900 RunCode: 2013-02-25T21:13:04 ID: CG4133EA Page 12 of 13
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
Project Name
Gross Residence
Date
2/25/2013
System Name
HVAC System
Floor Area
4,133
ENGINEERING CHECKS
SYSTEM LOAD
Number of Systems
1
COIL
CFM
Total Room Loads 2,179
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation 0
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
COOLING PEAK
COIL HTG.
PEAK
Heating System
Sensible
Latent CFM
Sensible
Output perSystem 56,000
44,204
2,065 1,616
60,943
Total Output (Btuh) 56,000
0
Output Btuh/s ft 13.5
2,601
4,678
Cooling System
0
0
Output perSystem 0
0
0 0
0
Total Output (Btuh) 0
0
2,065
0
Total Output (Tons) 0.0
2,601
4,678
Total Output (Btuh/s ft) 0.0
Total Output s ft/Ton 0.0
49,407
70,298
Air System
CFM perSystem
0
HVAC EQUIPMENT SELECTION
Airflow cfm
0
Furnace - A/C 0
0
56,000
Airflow (cfm/s ft)
0.00
Airflow (cfm/Ton)
0.0
Outside Air (%)
0.0%
Total Adjusted System Output 0 0
(Adjusted for Peak Design conditions)
I TIME OF SYSTEM PEAK Aug 3 PM
1 56,000
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
Outside Air
0 cfm
66 OF
66 IF pmmq 105 OF
Heating Coil
r
103 OF
TZVOM..._....
68 OF
COOLING SYSTEM PSYCHROMETICS (Airstream Temperatures at Time of Cooling Peak)
88168 IF
Outside Air
0 cfm
76 / 62 OF
76 / 62 IF 55 / 54 IF
Cooling Coil
46.4 %
56 / 54 °F
j ROOM' t
75/ 61 IF
EnergyPro5.1 by EnergySoft
User Number: 5900 Run Code: 2013-02-25T21:13:04 ID: CG4133EA
Page 13 of 13