Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
13060134
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18840 NEWSOM AVE CONTRACTOR:PHAN CONSTRUCTION PERMIT NO: 13060134 CO INC OWNER'S NAME: SINGAMREDDY KARUNAKAR R 870 S WOLFE RD DATE ISSUED:08/152013 OWNER'S PHONE: 4082428350 SUNNYVALE,CA 94086 PHONE NO:(408)737-8323 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL C1 COMMERCIALE] License Class es Lic.9 —7 BUILD A NEW 2 STORY SFDWL(2,581)SQ FT, TO INCLUDE 4 BEDROOMS AND 3 112 BATH,ATTACHED 2 Contractor Date CAR I hereby of rm that I am licensed under the provisions of Chapter 9 GARAGE 453 SQ FT,PORCH AREA 18 SQ (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and,effect. 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. Sq.Ft Floor Area: Valuation.$400000 �1 .I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37530019.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If n roof is END installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ WNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sate(Sec.7044, Business&Professions Code) 1,as owner of tate 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 1 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 Arca 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 25505,2 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or aut orae ag R �—Dater permit is issued. - _---�. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that 1 have read this application and state that die above information is correct.1 agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECTS DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses whieh 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18840 NEWSOM AVE CONTRACTOR:PHAN CONSTRUCTION CO PERMIT NO: 13060134 INC OWNER'S NAME: SINGAMREDDY KARUNAKAR R 870 S WOLFE RD DATE ISSUED:08/15/2013 Hn oil OWNER'S PHONE: 4082428350 SUNNYVALE,C PHONE NO:(408)737-8323 LICENSED CONTRACTOR'S DF,C.LARATION r r r r�'� BUILDING PERMIT INFO: BLDG ELECT PLUMB License t zJ T`"--.?-_L-ia., � �,. r� r r ~- '� { �'; ` '' } .'-'•�:�' v °^" MECH RESIDENTIAL COMMERCIAL Contractor ,. •C-1+1 f1 r� --. ' ;,,�; ..; , >: JOB DESCRIPTION:BUILD A NEW 2 STORY SFDWL(2,581)SQ FT, TO I hereby affirm that I am licensed under the provisions of Chapter 9 INCLUDE 4 BEDROOMS AND 3 112 BATH,ATTACHED 2 CAR (commencing with Section 7000)of Division 3 of the Business&Professions GARAGE 453 SQ FT,PORCH AREA 18 SQ Code and that my license is in full force and effect. 10/27/13 REVISION l-REMOVE&INFILL(2)WINDOWS IN KITCHEN,ADD I hereby affirm under penalty of perjury one of the following two declarations: SKYLIGHT TO KITCHEN,RELOCATE DOOR&WINDOW IN FAMILY ROOM, PI have and will maintain a certificate of consent to self-insure for Worker's STRUCTURAL CLARIFICATION FOR WINDOW ON 2ND FLOOR-ISSUED 10/22/13 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 Cade,for the performance of the work for which this permit is issued. Sq.Ft Floor Arca: Valuation:$400000 APPLICANT CERTIFICATION certify that 1 have read this application and state that the above information is APN Number:37530019.00 Occupancy Type: correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature _ 1� Issued by: /�/ �� - fid ��f 11 ❑ O\VNF,R-BUILDER DECLARATION hereby affirtn that I am exempt from the Contractor's License Law for one of RF,-ROOFS: the fallowing two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,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(See.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: 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 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 Cade,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 I certify that in the performance of the work for which this permit is issued,1 shall contaminants as defined by the Bay Arca 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,atter 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 Cade,I must „fig= -1OOwner or fixed agn, — ""-1,-�:•r` ` forthwith comply with such provisions or this permit shall be deemed revoked, -,.�_,�,,._ti,;::•. _,- 'I_c:y,f.nat� APPLICANT CERTIFICATION A �j 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct,1 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 pertormance of work's to building construction,and hereby authorize representatives of this city to enter far 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 ARCHITECT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUP> RTINO (408)777-3228• FAX(408)777-3333•building(cDcupertino.Org �J ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION!TI REVISIO /DEFERRED ORIGINAL PERMIT# �30 h ��3 T PROJECT ADDRESS Z7 OWNER NAME PHON711 32 E- 1 �� I STREETADDRESS CITY,STATE,ZIP 1 16 FAX CONTACT NAME STREETADDRESS CTTY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ COT+TRACTOR ❑COMRACrORAGENT ❑ ARCHrrECT ❑ENGINEER ❑ DEVELOPER ❑TENANT AIAV'%01 CONTRACrORNPW, LICENSENUMBER LICENSE TYPE BUS.LIC 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCH MECTIENGINEER NAME LICENSE NUMBER BUS.LIC 9 COMPANY NAME E-MAIL FAX STREETADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK ` .T 04V-- 40A1 1Z t L`a - EXISTING USE PROPOSED USE CONSTR.TYPE N STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA A BATHROOM I KITCHEN OTHER REMODELAREA RE EtffrAREA REMODELAREA PORCH 4>_D A TOTAL DECI1,TORCH AREA GARAGE AREA: Lj DETACH ❑ATTACH 9 DYWMNG UNITS. 13 A SECOND UNIT []YES SECOND STORY []YES BEING ADDED? ONO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF ISTHEBLDGAN ❑YES RECEIVED -` - TOTAL VALUATION: PLANNINGAPPLB []NO PLANKU GAPPROVALLErTER EICHLERHOME' ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating toacru,tior�l authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicanUAgent; 4 W-4141 Date: w X22, l/7 SUPPLEMENTAL IN ORMATION REQUIRED ' — ' Q PLAPI CIIECIC TYPE. "- ROUTING SLIP._ New SFD or Multifamily dwellings: Apply for demolition permit for ' existing building(s). Demolition permit is required prior to issuance of building };�' a� R.TIIeotJNTt a_f Burr nirrG PUAN iviy permit for new building, l 12 ExPRES& �p�/p�-PLANNING PLAN REViEwr, , Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ,E1 sT`ANDARDr I-� :'�v6RYcs, y in.vrt ` r LJ'"Pl11ILIC form if any Hazardous Materials are being used as part of this protect. �, �,E«ICARGE . -D FIREDEP.T _ Copy of Planning Approval Letter or Meeting with Planning prior to P � pP g g p MAJORi - �I��:SANITARY SEW ER➢ISTRICT,` submittal of Building Permit application. - �EN VI IZONATENTAL-'HEALTH BldgApp_2011.doc revised 06121111 CONSTRUCTION PERMIT APPLICATION 12 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION erool 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C U P E RT!N Q (408)777-3228• FAX(408)777-3333'building .cupertino.org 13 NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS + O Ree q r \PNM-375+4-30—Q1 L�lOWNER NAME `J h K t PHONE D� Z,&350 EMAIL STREET ADDRESS F,W 10M AV G CITY, STATE,ZIP�,'f •_.,•.r b O � FAX CONTACT NAME PHONE�[5+iL ��` ( [EMP�h �� STREET ADDRESS 07c) -S- f J R� CITY,STATE,ZS�,`�� `, ` ,.,,r7/ FAX -37 7,3,57 ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTORAGENr 9 ARCIITCECr(�❑UrENJGIGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME - LICENSE NUMBER LICENSE TYPE BUS.LIC r - COMPANY NAME E-MA FA STREET ADDRE S CITY,STATE,ZIP P ONE ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC M 2 CDMPANY A E-MAIL FAX n STREET ADDRESS CITY STATE,ZIP PION U DESCRIPTION OF WORK i EXISIINGUSE PROPOSED LEE CONSTR TYPE 11STORIESS USE TYPE OCC. SQ.FT. VALUATION(5) EXISTO _ .' 0 DEMO TOTAL AREA .0 A AREA NPTAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA DECK AREA TOTALDECIUPORCH AREA 'Ci,. A:'�'� EIACHATTACH #DWELLING UNIT& ISA SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? []NO ADDITION° []NO PRE-APPLICATION IF YES,PROVIDE COPY OF ISTIIEBLDGAN [J YES RLCE.I B -_"'s 'A N:, PLANNING APPL e ❑NO ROVALLITER EICHLERHOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized a nt to act on the property ov ner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work an verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building congtruction I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. oI}IITiZrkelf Et lilt' !Iftvj t s<' °- w SUPPLEMENTAL INFORMATION REQUIRED PL1N CIIECK TYPE ROUTINGSLIP New SFD or Multifamily dwellings: Apply for derrlolition permit for ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior t0 issuance Ofbuilding permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD PUBLIC WORKS form if any Hazardous Materials are being used as part ofthis project. ❑ LARGE FIRE DEPT Copy of Planning Approval Letter or Meeting With Planning prior to ❑ MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ IENVIRONNIENTALIIEALTII SldgApp_20!Ldoc revised 06/21111 CITY OF CUPERTINO FEE ESTIMATOR--BUILDING DIVISION ADDRESS: 18840 newsorn ave DATE: 06/1712013 REVIEWED BY: Mendez APN: BP#: 0&613 "VALUATION: 1$400,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY 2nd Unit? Yes • No PENi'AMATION USE: SFD or Duplex PERMIT TYPE: 1 R35FD WORK Build a new 2 story sfdwl (2,581)sq ftto include 4 bedrooms and 3 112 bath attached 2 car garage SCOPE 453 sq ft, porch area 18 sq OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 3,052 n _,; 6 IR3PLNCK $2,845.74 IR3INSP TOTALS: 3,052 $2,870.96 $2,845.74 Mech. Plain Check Plumb,Plan Check Elec.Plan Check 1 fech.Perini[Foo Plumb.Permit Fee: F.lec•.Permit Fee: r�oiff"11'111, bfech. Insp• 011ier Plumb Insp. Other Elec. Insp. Li Insp. Fee: Plumb. hisp.Fee: Flec. Insp.Fee, NOTE:This estimate does not include fees due to other Departments C.e.Planning,Public Works,Fire,Sanitary Sever District,School District,eta). These ees are based on the preflonina information available and are only an estimate Contact lire De i or ad[hr'1 in e. FEE ITEMS(Fee Resolution 11-053 G . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,870.96 Select a Misc Bldg/Structure Suppl. PC Fee: 0 Reg. Q OT rO.0 I hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,845.74 Suppl. Insp. Fee-.0 Reg. Q OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 #new Construction Tax: 1BCONST,4XR 1 units $641.96 Administrative Fee: Q Work Without Permit? © Yes (D No $0.00 Advanced Piannine Fee: IPLLONGR $396.76 Select a Non-Residential Building or Structure 0 TravelDocumentationFees: � Strona Motion Fee: 1BSEISMICR $40.00 Select an Administrative Item Blda Stds Commission Fee: IBCBSC $16.00 1 . .' SUBTOTALS: $6,811.42 $0.00 TOTAL FEE: $...x'1.42 Revised: 0412912013 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION W*PERMITTYPE: DDRESS: 18840 Newsome Ave DATE: 10/22/2013 REVIEWED BY: Sean PN: BP#: 13060134 *VALUATION: $0 Building Permit PLAN CHECK TYPE: Alteration 1 Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK Revision#1: Remove and infill 2 windows in kitchen; add skylight to kitchen; relocate door and SCOPE window in family room; structural clarification for window on second floor. vIL,oh.('ilmp Cha(:P I}I.f(�J:J.f?ho l.�ei�i��- �.����.�Di���r l,fi(,(;75 ,�f(7r.:r.. !'F•rrr;it Pee: 1:lr?SP:, f�(?!ilsr r`'6•&: ;1feC:. (:1'To`i7t l`e'i': o lier.i"ur.P.fnsp, C?PiFrrr r'._]'c,%nst:. Ll A.fecih. tns'p.F«': Ph'?m"'.lush. F'ee: Ilea In';!). Fite: NOTE: This estiurate does trot include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These ees are based on the prelilidnar information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 0 hours Plan Check,Hourly Supp!. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 $139.00 ISTPLNCK <= 10 s.f. PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes (F) No $0.00 Supp!. Insp. Fee:Q Reg. Q OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Pennit Fee: $0.00 Consf;uc";D6'( 1 tf.:: 1t�it�irl4,*.rra;f,= fcc�: Work Without Pennit? ® Yes (D No $0.00 (F) Advanced Planning Fee: $0.00 hours Inspections G) 1 i-dwi f)ctiinenia loo fi'e`: $139.00 ISTINSP Inspection,Hourly O�A Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS; $0.00 $278.00 TOTAU'PEE: $278.00 Revised: 10101!2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 O CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# 1 ,3 C? 6Q -j rJ],V OWNER'S NAME: PHONE# GENERAL CONTRACTOR: , ( BUSINESS LICENSE# Z- ADDRESS: 67o -S , CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino tusiness 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: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing ElectricalG C5'�Qld.G L iC�� �' Excavation -7�3/ / 3 Fencing Flooring/ Carpeting Linoleum /Wood Glass/Glazing Heating Insulation Landscaping Lathing z 9* Masonry Painting/Wallpaper Paving QQ Plastering Plumbing Roofing Septic Tank Sheet Metal �Lj �2Cip l G Sheet Rock W05 6E7MS PALGZ)QAJ 1 N G I ZS":�tQ Tile ZTUR Ale, —ru:s Owner/ ontrac r Signature Date INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope—Insulation; Roofing- Fenestration (Page 1 of 3) Site Address: Enforcement Agency: Permit Number: If more than one person has responsibilityfor installation of the items on this certificate,each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible,alternatively,the person with chief responsibilityfor construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check boxes require to be checked to ensure the mandato measures have been met. Description of Insulation 1. RAISED FLOOR Material: 9 Brand Name: ' 46R141 Thickness inebes):� t' Thermal Resistance(R-Value): ❑ §150(d):Minimum R-1349sulation in raised wood-frame floor or equivalent U-factor. 2. SLAB FLOOR/PERIMETER Material. Brand Name: Thickness(inc es): Thermal Resistance(R-Value): Perimeter Insulation Depth(inches): ❑ §i 50(I):Water absorption rate for the insulation material alone without facings is no greater than 0.3%;water vapor permeance rate is no greater than 2.0 perm/inch and shall be protected from physical damage and UV light deterioration. 3. EXTERIOR WALL a.Insulation Type(e.x. Batt,Loose Fill, Spray Foam) W" a.Thermal Resistance(R-VaIue): �� b. .Ins ulat o Type(e.x.Batt,Loose Fill,Spray Foam) b.Thermal Resistance(R-Value): Brand: Kf&! ' Spray/Loose fill)Installed Actual Thickness Spray/Loose fill) (inches): Contractor's min installed weight/W lb Manufacturer's ins ed weight per square foot to achieve Thermal Resistance(R-Value) ❑ §150(c):Minimum R-13 insulation in wood-frame wall or equivalent U-factor. Exterior Foam Sheathing(rigid Insulation) Material: Brand Name: Thickness(inches) : Thermal Resistance(R-Value) ; 4. FOUNDATION WALL Material: Brand Name: Thickness(inches): Thermal Resistance(R-Value): 5. CEILING Batt or Blanket Type:_ B 'r'� Brand Name: Loose Fill Type: Thermal Resistance(R-Value): Spray Foam Type; AIIA _ Brand Name: Installed Actual Thickness('hes): Contractor's min installed weight/ft' lb Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value); ❑ §150(a):Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor. 6. ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER Material: Aa/A Brand Name: Material: Brand Name: Thickness(inches): Thermal Resistance(R-Value): 11 §11 B(a): Insulation installed meets Standards for Insulating Material. ❑ §150(g):Mandatory Vapor barrier installed in Climate Zones 14 or 16. 1 2008 Residential Compliance Fornis August 2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope—Insulation; Roofing- Fenestration (Page 2 of 3) Site Address: 10Mt4PLWMEnforcement Agency: Permit Number: � c COO r Description of R olling Products CRRC Product ID Manufacturer Product Roof Roof Product Initial Solar Aged Solar Thermal Number` Information Brand/Model T e Area Slope Weight 2 Reflectance Reflectance4 Errittance 03 toM70F I ❑3 1. 77ze CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at ww.coo)roofs.org/pmducls/search.php 2. The weight in Ibs per square feet of the roofing product being installed. 3.Check box if the Aged Reflectance is a calculated value using the equation below,footnote 4. 4,If the aged reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the initial reflectance value from the directory and use the equation(0.2+0.7( j,,j jot—0.2)to obtain a calculated aged value. ❑CHECK APPLICABLE BOX BELOW IF EXL'MPT FROM THE ROOFING PRODUCT"COOL ROOF"REQUIREMENT. ❑ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool Roof criteria. ❑ Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 lb/ is exempted from the above Cool Roof criteria. To apply Liquid Field Applied Coatings,the coating must be applied with a minimum dry mil thickness of 20 mils across the entire roofsurface and meet minimum performance requirements listed in§118(i 3 and Table 118-C. Select the applicable coating ❑ Aluminum-Pigmented,Asphalt Roof Coating ❑Cement-Based Roof Coating ❑Other V ❑CRRC-1 Label Attached to CF-6R (Note if no CRRC-1 label is available,this compliance method cannot be used and another method is required to meet compliance). FENESTRATION/GLAZING Product # Total Quantity Add.Exterior Comments/ Manufacturer/Brand Name U- Product of NFRC of Like Product Area Shading Bev. Location/Special Item GROUP LIKE RODUCTS factor] SHGC' Panes Certified1•2 (Optional) fe or Overhang Features F)114 fig' 2 3 4 5 6 7. 9. 1. Use values from a fenestration prodact's NFRC Certified Label.Far fenestration products without an NFRC label,use the default values from Section 116.Table 116-A and 116-B of the 2008 Energy Ed ciency Standards. 2.NFRC Label Certificates shall not be renraved until the buildin inspector has rerifred the efficiency,Enter Yes or No. ❑ §116(4)1:Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. ❑ 4116(a)2 and 3:Actual fenestration products installed are equivalent to or have a lower U-factor and/or a lower SHGC than that specified on the Certificate of Compliance(Fore CF-1R). ❑ §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§10-11 l(a) ❑ §117:Exterior doors and windows weather-stripped;all joints and penetrations caulked and sealed. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope — Insuktion; Rooft; Fenestration (Page 3 of 3) Site Address:109*145WK AV& Enforcement Agency: Permit Number- DECLARATION STATEMENT + 1 certify under penalty ofpedury,under the laws of the State ofCalifomia,the information provided on this form is true and correct. o I am eligible under Division 3 oftbe Business and Professions Code to accept responsibility for Construction,or an aunborized representative ofthe person responsible for construction(responsible person). + I certify that the installed features,materials,components,or nunufactured devices identified on this certificate(tbe installation)conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. e I reviewed a copy of the Certificate ofCompliance(CF-1R)form approved by the enforcement agency that identifies the specific reqs irenwrus for the itictallatbrL I certify that the requhrrnents detailed on the CF-1R that apply to t1m installation bane been met. o I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued forthe building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or GeneralContractor or Buulder/Owmr) Responsible Person's Name: Responsible Perso S tune: CSLB License: Date Signed: Position With Company(Title)- Z, 2008 Residential Compliance Forms August 2009 2010 CALGREEN CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building 0-cupertino.orA PURPOSE: 4f The 2010 CalGreen Code applies to all newly constructed hotels, motels, Iodgin�g�H uses, dwellings, dormitories, condominiums, shelters, congregate residences, employee housing, factory-built housing and other types of swellings with sleeping accommodations and new accessory buildings associated with such uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: SK REDDY RESIDENCE Project Address: 18840 NEWSOM AVE, CUPERTINO CA 95014 Project Description: REPLACE EXISTING SINGLE STORY DWELLING WITH NEW TWO STORY HOSUE Instructions: l; " 1. The Owner or the Owner's agent shall employ a Iicene�I ro s OC-all experienced with thet2010 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 owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - 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 Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column3 MANDATORY FEATURE OR MEASURE Project Verification Requirements . . .1 PLANNING AND DESIGN Planning and Design -Site Preservation 4.104.1 A site plan and inventory of the site is developed and used to minimize site disturbance in order preserve desirable existing natural resources and ❑X minimize future adverse effects on the proposed structure. Planning and,Design -Site Development 4.108.2 A plan is developed and implemented to manage storm water drainage during construction. 4.108.3 The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage X❑ [] system will manage all surface water flows. Page 1 of 5 CalGreen_2010.doc revised 02114/11 A4.5 rQUALITY Fireplace$ m A n 4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- ❑ ❑ burning fireplace, or a sealed woodstove. 'c titra t w i 4.504.1 Duct openings and other related air distribution component openings © ❑ shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks shall be compliant with VOC and ❑ ❑ other toxic compound limits. 4.504.2.2 Paints, stains and other coatings shall be compliant with VOC limits. © ❑ 4.504.2.3 Aerosol paints and other coatings shall be compliant with product �] ❑ weighted MIR Limits for ROC and other toxic compounds. 4.504.2.4 Documentation shall be provided to verify that compliant VOC limit ❑ ❑ finish materials have been used. 4.504.3 Carpet and carpet systems shall be compliant with VOC limits. © ❑ 4.504.4 Fifty(50)percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance I� ❑ Schools(CHPS) Low-emitting Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Particleboard, medium density fiberboard(MDF), and hardwood plywood used in interior finish systems shall comply with low formaldehyde ❑ ❑ emission standards. r ash ' Kn a Inteior Moistwre Cvn'trol 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. []X, ❑ 4.505.3 Moisture content of building materials used in wall and floor framing is ❑ ❑ checked before enclosure. Indoor,Air Quality and Exhaust z 4.506.1 Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comforth R 5 y !. M•'1�'A 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the fan is off. Covers or louvers shall have a minimum ® El insulation value of R-4.2. 4.507.2. Duct systems are sized and designed and equipment is selected using the following methods: 1. Establish heat loss and heat gain values according to ACCA Manual J or equivalent. 2. Size duct systems according to ACCA 29-D (Manual D)or equivalent. 3. Select heating and cooling equipment according to ACCA 36-5 (Manual S) or equivalent. INSTALLER yQUALIFICATIONS Q11a11fICatIORS ° g oe t. 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. El 702.2 The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect 0 El and verify. Verifications 703.1 Verification of compliance with CALGreen may include construction documents, plans, specifications builder or installer certification, inspection reports, or other methods acceptable to the enforcing agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. CALGREEN SIGNATURE DECLARATIONS Project Name: SK REDDY RESIDENCE Project Address: 18840 NEWSOM AVE, CUPERTINO CA 95014 Project Description: REPLACE EXISTING SINGLE STORY DWELLING WITH NEW TWO STORY HOSUE SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification" and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised 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 forth in the 2010 California Green Building Standards Code as adopted by the City of Cupertino. AjV V AV A-A/1 06/06/2011 Owner's Sign a Date KARUNA R REDDY SIN MREDDY Owner's Name (Please Print) / 06/06/20111 Desi rofessional's S' atureDate T EU PHAN, ARCHITVC-T Design Professional's Name (Please Print) 0610612011 Signature of License Professional responsible for CalGreen compliance Date THIEU PHAN, ARCHITECT 408.690.3281 Name of License Professional responsible for CalGreen compliance (Please Print) Phone thieuphan@gmail.com Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date THIEU PHAN, ARCHITECT 408.690.3281 Name of License Professional responsible for CalGreen compliance (Please Print) Phone THIEU PHAN,ARCHITECT Email Address for License Professional responsible for CalGreen compliance r�9 Rri OFFICE OF COMMUNITY DEVELOPMENT R�V/Fy ���' Qtr ,g aQp"� FO 6�1� nt CITY HALL Re�,r���d R Cpd!C 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ey,• Ditij�p C U P E RTI N O (408)777-3308•FAX(408)777-3333 •plan ning@cupertino.orq May 28,2013 y Jai Phan Architects ',; `*• Attn:Phoi Phan � r7 >J 870 S Wolfe Rd g' Sunnyvale,Ca 95014 SUBJECT: TWO STORY PERMIT AND MINOR RESIDENTIAL PERMIT ACTION LETTER— Applications R-2013-20 and RM-2013-16 ••r' This letter confirms the decision of the Director of Community Development, given on May 28,2013; approving a Two Story Permit(R-2013-20) to allow the construction of a 3,035 square foot single family residence;and a Minor Residential Permit(RM-2013-16) to allow a front facing, second story balcony on the new residence,located at 18840 Newsom Avenue, with the following conditions: 1. APPROVED PROTECT This approval is based on a plan set entitled, "SK Residence, 18840 Newsom Ave, Cupertino, CA, 95014, New Two Story Home"consisting of 11 sheets labeled, "A.00 to A.10" dated "Received May 2, 2013, except as may be amended by conditions in this resolution. 2. ANNOTATION OF THE CONDITIONS OF APPROVAL The conditions of approval set forth shall be incorporated into and annotated on the building plans. 3. ACCURACY OF THE PROTECT PLANS The applicant/property owner is responsible to verify all pertinent property data including but not limited to property boundary locations, building setbacks, property size, building square footage, any relevant easements and/or construction records. Any misrepresentation of any property data may invalidate this approval and may require additional review. 4. CONSTRUCTION PLAN SET REVISIONS/CLARIFICATIONS Prior to issuance of building permits, the construction plan submittal shall include the following information: a. Sheet A.04-Please indicate a 6minimum height for the proposed Italian Cypress. b. Sheet A.04-Please update the plans to show a 180 degree view angle for the second story balcony.Additional privacy planting, or a waiver from the affected property owner,shall be required for westerly views from the front balcony to areas behind the adjoining properties 20'front setback line. 5. COMPLIANCE WFIH PUBLIC WORKS CONFIRMATION FORM The project shall comply with the requirements indicated on the Public Works Confirmation form dated 419/2013, including, but not limited to, dedications, easements, off-site improvements, undergrounding of utilities, all necessary agreements, and utility installations/relocations as deemed ,Two-Story and Minor Residential Permit Action Letter Page 2 R-2013-20 and RM-2013-16 necessary by the Director of Public Works and required for public health and safety. The Public Works Confirmation is a preliminary review, and is not an exhaustive review of the subject development.Additional requirements may be established and implemented during the construction permitting process. The project construction plans shall address these requirements with the construction permit submittal, and all required improvements shall be completed to the satisfaction of the Director of Public Works prior to final occupancy. 6. PRIVACY PLANTING The final privacy-planting plan shall be reviewed and approved by the Planning Division prior to issuance of building permits. The variety, size, planting distance shall be consistent with the City's requirements, 7. PRIVACY PROTECTION COVENANT The property owner shall record a covenant on this property to inform future property owners of the privacy protection measures and tree protection requirements consistent with the R-1 Ordinance, for all windows with views into neighboring yards and a sill height that is 5 feet or Iess from the second story finished floor. The precise language will be subject to approval by the Director of Community Development. Proof of recordation must be submitted to the Community Development Department prior to final occupancy of the residence. 8. LANDSCAPE PROTECT SUBMITTAL: Prior to issuance of building permits, the applicant shall submit a full landscape project submittal per sections 14.15.040 A, B, C, and D of the Landscaping Ordinance if more than 2,500 square feet of landscaping area is proposed. The Water-Efficient Design Checklist (Appendix A of Chapter 14.15), Landscape and Irrigation Design Plans, and Water Budget Calculations shall be reviewed and approved to the satisfaction of the Director of Community Development prior to issuance of building permits. 9. CONSULTATION WITH OTHER DEPARTMENTS The applicant is responsible to consult with other departments and/or agencies with regard to the proposed project for additional conditions and requirements. Any misrepresentation of any submitted data may invalidate an approval by the Community Development Department. 10. EXTERIOR BUILDING MATERIALS/TREATMENTS Final building exterior treatment plan (including but not limited to details on exterior color, material, architectural treatments and/or embellishments) shall be reviewed and approved by the Director of Community Development prior to issuance of building permits. The final building exterior plan shall closely resemble the details shown on the original approved plans. Any exterior changes determined to be substantial by the Director of Community Development shall require a minor modification approval with neighborhood input. 11. INDEMNIi~ICATION To the extent permitted by law, the Applicant shallindemnify and hold harmless the City, its City Council, its officers, employees and agents (the "indemnified parties") from and against any claim, action, or proceeding brought by a third party against the indemnified parties and the applicant to attack, set aside, or void this ordinance or any permit or approval authorized hereby for the project, including (without limitation) reimbursing the City its actual attorneys' fees and costs incurred in defense of the litigation. The City may, in its sole discretion, elect to defend any such action with attorneys of its choice. Two-Story and Minor Residential Permit Action Letter Page 3 R 2013-20 and RM-2013-16 12. NOTICE OF PEES,DEDICATIONS,RESERVATIONS OR OTHER EXACTIONS The Conditions of Project Approval set forth herein may include certain fees, dedication requirements,reservation requirements, and other exactions. Pursuant to Government Code Section 66020(d) (1),these Conditions constitute written notice of a statement of the amount of such fees, and a description of the dedications, reservations, and other exactions. You are hereby further notified that the 90-day approval period in which you may protest these fees, dedications,reservations, and other exactions, pursuant to Government Code Section 66020(a), has begun. If you fail to file a protest within this 90-day period complying with all of the requirements of Section 66020, you will be legally barred from later challenging such exactions. Please note that if this permit is not vested withirt a year, it shall expire on May 28, 2014. Staff has made all the findings that are required for approval of a Two-Story Permit and Minor Residential Permit as required by the of Cupertino's Municipal Code, Chapter 19.28.140 (E) and (A). Also,please note that an appeal of this decision can be made within 14 calendar days from the date of this letter. If this happens, you will be notified of a public hearing, which will be scheduled Before the Planning Commission. Sincerely, Ste ose Associate Planner 408-777-3286 stephenrocupertino.org Enclosures:Approved Plan Set CC: Kari+nakar Reddy,1259 Ocaso Camino,Fremont,CA 94539 v 1 PUBLIC WORKS CONFIRMATION FORM ILI Public.Works Deparbnerif 10300 Torre Avenue (408)777-3334/Pax(408)777-3333 Cupertino,CA 95014 publicworks@mpertino.org C V PERTs NCi http://www.capertrno.org/pubHcworks A Public Works confirmation form,if required,must be completed prior to project submittal to the Planning Department. The fee for the confirmation is$263.00. The purpose of this confirmation is to identify preliminary Public Works issues, which may adversely affect the application. Please submit this form, the fee, and a copy of the site plan to the Public Works Department for review. The Public Works Department can be reached at(408)777-3354. Project Address: AVLEEmail Address: ` ,Lev" Applicant Name: Phone No: ►22�°' APP, 31S'13o-o; "**For Public Works Department Use Only*" PW Conf enation Required($263) f5s 110'-'10 1`I746 PW Confirmation Not Required Addition: Single Family Dwelling Flood Zone: Requirements: ❑ Dedicate Right-of-way(road): (A ❑ Easement(streetlight): Offsite improvements required(circled):sidewalk,curb and gutter,curb ramp,driveway, pavement, street lightAZtreet tree ❑ Registered civil engineer required to design grading plans or improvement plans H Clearly show all utility limes from the house/project site to the street(electric,electric panel,gas, water,sewer). Indicate as new(N) or existing(E) ® Underground all overhead utility service to new house or new electric panel M/ Show onsite drainage on site plan with direction and slope percentage ❑!Include relevant City Standard notes and Details,on plans t3 croachment ervu' r DevelopmentAgreement ❑ Sireamside Permit F Ulia� {ZLI'F 6J1J 1�IItiC- orrX11COl, V Tr i TIC S ❑ Soils letter/report ✓ Submit preliminary title report and Quitclaim underground water rights Comments WC(7 o u5i i E omm c'c r/lz d G rfI51 SA"f lC,` Ta SHE sf,7 r7' CITY SfiAVAIPP 9,1IVAA Y r9l�',e'ale# r7, E 1AT7W440 i�- IX'S!le-D, Signa e Me Date '3 P age 6 of 6.rMAYDy lu'� July I Revised 71111011 Sy (VJ 2010 CALGREEN RESIDENTIAL CHECKLIST -- MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildingAcupertino.org PURPOSE: The 2010 CalGreen Code applies to all newly constructed hotels, motels, lodging houses, dwellings, dormitories, condominiums, shelters, congregate residences, employee housing,factory-built housing and other types of swellings with sleeping accommodations and new accessory buildings associated with such uses. F)dsting site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: I:—:,- 1 C� Project Address: AYE Ger--L=zr bn Project Description: R1 W -rV4 fST-ORY Instructions: 1. The Owner or the Owner'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 owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 -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 Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements A4.1 PLANNING . ■ DESIGN Planning and Design -Site Preservation 4.104.1 A site plan and inventory of the site is developed and used to minimize site disturbance in order preserve desirable existing natural resources and ® ,] minimize future adverse effects on the proposed structure. Planning and Design -Site Development 4.105.2 A plan is developed and implemented to manage storm water drainage during construction. 4.106.3 The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage XL1 system will manage all surface water flows. Page 1 of 5 CalGreen 2010.doc revised 08127/11 I ,.2 ENERGY EFFICIENCY General , 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. AI WATER1 CONSERVATION Indoor Water Use 4.303.1 Indoor water use shall be reduced by at least 20 percent using one of the follow methods. ❑ Water saving fixtures or flow restrictors shall be used per Table 4.303,2. ❑X ❑ ElA 20 percent reduction in baseline water use shall,be demonstrated per As of 7/01/2011 Table 4.303.1. 4.303.2 When using the calculation method specified in Section 4.303.1, multiple showerheads shall not exceed maximum flow rates. As of 7/01/2011 4.303.3 Plumbing fixtures(water closets and urinals) and fittings (faucets and I� showerheads) shall comply with specified performance requirements. As of 7/01/2011 Outdoor Water Use 4.304.1 Automatic irrigation systems installed at the time of final inspection shall be weather-based. A4.4 MATERIAL, CONSERVATION AND RESOURCE Enhanced Durability and Reduced Maintenance 4.406.1 Joints and openings.Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected I� against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. Construction Waste Reduction, Disposal and Recycling 4.406.2 Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall X❑ be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 An operation and maintenance manual shall be provided to the building occupant or owner. A4.5 ENVIRONMENTAL QUALITY es,,- 7o 4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- burning fireplace, or a sealed woodstove. .611tan- 1, t tbirdro"I" tj 4.504.1 Duct openings and other related air distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints, stains and other coatings shall be compliant with VOC limits. 4.504.21 Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic compounds. 4.504.2.4 Documentation shall be provided to verify that compliant VOC limit finish materials have been used. 4.504.3 Carpet and carpet systems shall be compliant with VOC limits. 4.504.4 Fifty(50) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools(CHPS) Low-emitting Materials List or be certified under the Resilient Floor Covering Institute(RCFI) FloorScore program. 4.504.5 Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall comply with low formaldehyde emission standards. Ilnterioir mA olstu'r 6 Control 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. 4.505.3 Moisture content of building materials used in wall and floor framing is checked before enclosure. Page 3 of 5 CalGreen-201 0.doc revised 08/27/11 Indoor Air'Quality and Exhaust 4.506.1 Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comfort 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the tan is off. Covers or louvers shall have a minimum X❑ insulation value of R-4.2. 4.507.2. Duct systems are sized and designed and equipment is selected using the following methods: 1. Establish heat loss and heat gain values according to ACCA Manual J or equivalent. 2. Size duct systems according to ACCA 29-D (Manual D)or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S (Manual S) or equivalent. INSPECTORINSTALLER AND SPECIAL QUALIFICATIONS Qualifications 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect X❑ and verify. 4 Verifications 703.1 Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection reports, or other methods acceptable to the enforcing agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. CALGREEN SIGNATURE DECLARATIONS Project Name: SKIZM– DYIc C= Project Address: l E50A-y N.L= We-;& Ayr-, 6o ttm-gnw (-/.,, Gj,Sn�� Project Description: 6 e W —rW 13 1 arc (r SECTION 9 — DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification"and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised 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 forth in the 2010 California Green Building Standards Code as adopted by the City of Cupertino. gh-A" - - — Owner's !m #ure ate Owner's Name (Please Print) �- 7Z 7 esign Proessio al's Signature Date AC — I --U Design ProfessionalName (Please Print) r I S�nature of i e Professional responsible for CalGreen compliance Date 7T4411 "cHrrj�C-T Z�l 2/J Name of License Professional responsible for CalGreen co pliance(Please Print) Phone i u, til 9 k,?-f4?0--32- J Email Address for License ProlMssional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of license Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen 2010.doc revised 08/27/11