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14080246 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10405 MANN DR CONTRACTOR:RICHARD HARO PERMIT NO: 14080246 CONSTRUCTION OWNER'S NAME: SHRIDAR SUBRAMANIAN 2I50 MANGIN WAY DATE ISSUED: 10/03/2014 OWNER'S PHONE: 4083525058 SAN JOSE,CA 95148 PHONE NO:(408)532-1755 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL 499 SQ FT ADDITION THROUGH OUT(E)SFDWL,PORCH License Class----—_ Licrr..4 70�1�� (15)SQ FT,REMODEL THROUGH OUT 1667 SQ FT Contractor RlC , W Date REVISION#1-ADD 77.5 SQ FT FRONT PORCH,CHANGE I hereby affirm that 1 am licensed under the provisions of Chapter 9 ROOF FRAMING-ISSD 1/6/2015 (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 Comp nsation,as provi ded for by Section 3700 of the Labor Code,for the ep ance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$215000 1 ve 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:32645021.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l 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 D 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 F M 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. Additionafy,the applicant understands and will comply Issued by: Date: with all no - int source regulati s per the Cupertino Municipal Code,Section 9.18. l RE-ROOFS: Signature Date f All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.I2 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 Ai Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Mnicipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sc ns 550555 Hand 11 4. Section 3700 of the Labor Code,for the performance of the work for which this (p Owner or authorized agent; Date: 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 1 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting ofthis 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: 10405 MANN DR CONTRACTOR:RICHARD HARO PERMIT NO: 14080246 CONSTRUCTION OWNER'S NAME: SHRIDAR SUBRAMANIAN 2150 MANGIN WAY DATE ISSUED: 10/03/2014 OWNER'S PHONE: 4083525058 SAN JOSE,CA 95148 PHONE NO:(408)532-1755 I/Y LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL D 499 SQ FT ADDITION THROUGH OUT(E)SFDWL, PORCH License Class1� Lic.# �i (15)SQ FT,REMODEL THROUGH OUT 1667 SQ FT Contractor Q 1 L tQ AMW Date 60/4(1 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the mance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$215000 fi-er and will maintain Worker's Compensation Insurance,as provided for by on 3700 of the Labor Code,for the performance of the work for which this APN Number:32645021.00 Occupancy'Cype: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PER T EXPIRESIF ORK IS NOT S'T'ARTED correct. 1 agree to comply with all city and county ordinances and state laws relating WITH 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 DA FROM LAST CALLED INSPEC ION. 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 er the Cupertino Municipal Code,Section 9.18. RE-ROOFS: SignatureRJX&. Date OCA .2.1-wif 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 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 sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm 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 Q lity Management District I performance of the work for which this permit is issued. will maintain compliance w' a Cupertino Munic pal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safcty Code,S t' ns 2 505,255 n 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: lo.; 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,1 must l 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the l 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION f` 10300 TORRE AVENUE• CUPERTINO, CA 95014- 5 J V 9 (408)777-3228• FAX(408)777-3333• buddin cu erti o.or CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI REVISI /DEFERRED GINAL PERMIT PROJECT ADDRESS %® 151 ` W ( APN# Q,/yV��r ,e f/�� 7 OWNER NAME �[1/,!/J��f1 Q�l�j, Q.�r � /'jt`.j� E-MAIL STREET ADDRESSihfF]7�G!//�//c/��� ✓(�'��� , /V CITY, E �M(JJ T/ /� FAX CONTACT NAME////�/� �/� P • L/'V L�+�✓/ E �X T , `?J S��RESW/�'j f ,4 ,/� CITY,S�V_�6 `�1 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑TENANT CON Og� LICE WR LIQ SE TYPE BUS.LIC# COMPANY NAME J E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WOR JW 41 CA 10 ode 01 EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREATOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT [I YES SECOND STORY C]YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY TO J VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER H 1E? ❑NO By my signature below,I certify to each of the following: I am the pr erty owner or authorized agent to act on the property owner's behalf. I have read this application and the informatio ve provided is correct. I have re he Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relat g t buil ing construct I a 2e epresentat of Cupertino to enter the a i ve-i ntif�d�operty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQ PLAN CHECK YPE. RourlNGslr New SFD or Multifamily dwellings: Apply for demolition rmit for Er OVER-rHE COUNTER' 1 ❑"BUILDINGPLAN RE«w existing building(s). Demolition permit is required prior to issuance of building " permit for new building. (] EXPREss ©•''PLANNING PLA IR i Ew _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure d sTnNnARD O:PVBLIcwoRxs form if any Hazardous Materials are being used as part of this project. 1] LARGE D,,FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR D SANITARY SEWER DISTRICT. submittal of Building Permit application. ❑' ENVIRONTIENTALHEALTH BldgApp_2011.doc revised 06/21/11 c P CONSTRUCTION PERMIT APPLICATION �� COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISIO 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•build ingacupertin o.ora \ ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TT ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROTECT ADDRFSS �': � qjv� t ��.-� AP'N# TE NAME PH NE it { C� i STREET ADDRESS CITY, NATE,ZIP FAX IJ [. • E� f �� r CONTACT NAME *�'r /� �'1 r-�-F ,�. v i. PHONE .. l " •; E-NIA11, y q♦ i'L i •�r STREET ADDRESSCi'1'Y STATE, ZIP �q 1 F X 7 L. ❑OWNER ❑OWNER-BUILDER ❑ OWNER AGENT AcoNTRAcToR ❑CONTRACTORAGENT ❑ ARCH1rECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACT NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# ai r , �f� T.-. a9/0 COMPANY NAME : ' ;� .P_�.1 1. 'r� E-MATE �i J! r� FAX STREETt CITY,STATE, y - PHONE •j f •y'. t: A. :77 1477 Ci.. LICENSE NUMBER 1 t�a BUS.LTC# 'i!OMPANY N i i" A E-MAIL i 1 FAX '4> t-'-j: 4�t ���, ''1 '�: i 4' („ `1 •` 'JG.-'�f. : t� } STR ET ADDRESS CCTV,SLATE,ZIP , .+ PHONE I ry -2 E20' _J.7 s � 1 DESt;Rt{1�;T�f�ON t)F OR Y'v tl .-t' . , 11 +) .rt ' l EXISTING USE PROPOSED USE CONS TIt.TYPE #STORIES r T`i- J r2, lJ � 1/nJ USE TYPE OCC- SQ.Fr. VALUATION(5) EXISTG I NEW FLOOR DEMO V TOTAL AREA ° 1'�� AREA X;A d"� AREA NET AREA BATHROOM 1 `KITCHEN OTHER ` REMODEL AREA REMODEL AREA REMODEL AREA J-­/ O PORCH AREA DECK AREA TOTAL OECK"R�'H AREA GARAGE AREA: DCTAL7i ATTACH ZmcJej I #DWELLING lJ1V1'rS: IS ASECOND UNIT [:]YES SECONDSTORV ❑YEs BEING ADDED? ONO .UNHTIoN? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE OLDG AN ❑YES RLtEtVETI$ OTAL VALUATION. PUNNING APPL# NO PUNNING APPROVAL LF-TFA F.ICRLFR BOMF.? ❑NO By my signature below,1 certify to each ofthe following: I am theowner or authorized agent to act o e property owner's behalf I have read this application and the information 1,WweWovided is correct_ T have read Jhe Description of Work and verify it is accurate- I agree to comply with all applicable local ordinances and state laws rely' Idi eonstructit I au esentadves of Cupertinio to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: — �L Date: SUPPLEMENTAL INFORMATION REQUk ll PLAN CHIECt[gypg ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for nwit Tim-t OtlNTER bill"ING PIAN REYIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. .-ExF rt UAN1WGPLANREVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD 0 x arwou" form if any Hazardous Materials are being used as part of this project. 0 _Copy of Planning Approval Letter or Meeting with Planting prior to submittal of Building Permit application. 1N.4JtHt �TITARY SE�YTaR utRTRTCT a ENVIROT+MENTALHEALTH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10405 mann dr DATE: 12/03/2014 REVIEWED BY: Mendez APN: BP#: `VALUATION: 1$12,000 °PERMIT TYPE: Building PermitPLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION USE: PERMIT TYPE: WORK REVISION #1- ADD 77.5 SQ FT FRONT PORCH CHANGE ROOF FRAMING SCOPE E17-- E] --i- NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the prelimina information available and are only an estimate. Contact the Detor addn'l info. FEE ITEMS(Fee Resolution II-053 Ef' - J :L FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure Suppl. PC Fee: Q Reg. 0 OT Q,0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-(D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes d No $0.00 ) Advanced Planning Fee: $0.00 Select allon-Residential E) Building or Structure i Strong, Motion Fee: IBSEISMICR $1.56 1 # Revisions Bids Stds Cornmission Fee: IBCBSC $1.00 $716.00 IREVRESADD Addition SUBTOTALS: $2.56 $716.00 TOTAL FEE: $718.56 Revised: 10/01/2014 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10405 mann dr DATE: 08/25/2014 REVIEWED BY: Mendez APN: BP#: -VALUATION: $215,000 ;-PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY 2nd Unit? •Yes No PENTAMATION USE: SFD or Duplex OTC? ®Yes (j)No PERMIT TYPE: 1 R3SFDADD WORK 499 sq ft addition through out a sfdwl porch 15 sq ftremodel through out 1667 sq ft SCOPE 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 514 $2,654.00 IR3PLA'CK $1,666.00 IR3INSP TOTALS: 514 $2,654.00 $1,666.00 MECH,HOURLY 0 Yes (2) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY 0 Yes (2)No NOTE: This estimate does not include fees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School District, etc. . These ees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fcc Resolution 11-053 L ,,7'1=73� FEE QTYIFEE MISC ITEMS Plan Check Fee: $2,654.00 1 667 s.f. Remodel, Other Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $5,172.00 IREMRESz PME Plan Check: $0.00 Permit Fee: $1,666.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes 0 No $0.00 0 Advanced Planning Fee: IPLLONGR $71.96 Select a Non-Residential G Building or Structure i Stroll& Motion Fee: IBSEISMICR $27.95 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $9.00 SUBTOTALS: $4,428.911$5-7172-0-0- TOTAL FEE: $9,600.91 Revised: 07110/2014 Building Department City Of Cupertino 10300 Torre Avenue /Telephone: upertino, CA 95014-3255 408-777-3228 CU P E RTI NO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: fj /(//(/ PERMIT# OWNER'S NAME: 106& PHONE# O,G - !-32 GENERAL CONTRACTOR: 121.6 Q BUSINESS LICENSE# Z _4044 ADDRESS:/Zl5DM&W(JJ Uf CITY/ZIPCODE: ,`j 5C *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: %/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork 4 f '2 Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping 2*-1i2F" V195K! � 174nepe 'D&.uv2 Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Co tra or Signature Date CALGREEN SIGNATURE DECLARATI 737F F I L. Project Name: Project Address: Project Description: SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification"and SUBMIT THE ENTIRE CHECKLIST(COLUMNS 2 AND 3) WITH THE PLANS AND BUILDING PERMIT APPLICATION TO THE BUILDING DEPARTMENT. The owner and design professional responsible for compliance with CalGreen Standards have reviewed 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 2013 Califomia Green Building Standards Code as adopted by the City of Los Altos. Owner's Signature Date Owner' a(Please Print) .16,J)IO-A-19 - Desigrf Professional's Signatu Date Design Professional's Name(Please Print) Signature of Green Point Rater Date Name of Green Point Rater(Please Print) Phone No. Email Address for Green Point Rater License No. SECTION 2 — IMPLEMENTATION VERIFICATION Complete,sign and submit the completed 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 suffi lent documentation to verify and certify that the project identified above was constructed in accordance with this Green B [ding Checklist and in accordance with the requirements of the 2013 California Green Building Standards C e as a ted by the City of Los Altos. Signature o rKV Date i Name of Licensed Green Point Rater(Please Print) Phoffie No. Email address for Licensed Green Point Rater License No. yos 1,t.TOS.�,• 2013 CALGREEN RESIDENTIAL CHECKLIST MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION KIRK BALLARD, BUILDING OFFICIAL ONE NORTH SAN ANTONIO ROAD • LOS ALTOS, CA 94022-3088 (650)947-2752 • FAX(650)947-2734• WWW.LOSALTOSCA.GOV PURPOSE: The 2013 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 dwellings with sleeping accommodations and new accessory buildings associated with such uses. This section also applies to additions and alterations where there Is an Increase in conditioned space and specifies that these requirements only apply to the specific area of the addition or alteration. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALgreen. **If your arolect totals 300 SQ. ft or less of addition and/or structural remodeled area combined you will NOT be required to obtain a third-party rater. You will still be responsible to follow all Residential Mandatory Measures as applicable to your project Please incorporate all pages of this checklist except the CALGreen Signature Declaration page Into your plans**. Project Name: S �� 'A►�l•q-kl Project Address: /�r/I d? Project Description, q&e -bR)P T k_-6 YdO29!& Instructions(for projects of 300 sq.ft.or more): 1. The owner or owner's agent shall employ a licensed qualified green-pant rater(www.builditgreen.org)experienced with the 2013 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 green-point rater,in collaboration with the owner and the design professional shall review Column 2 of this checklist,and initial all applicable measures,sign and date Section 1-Design Verification at the end of this checklist, prior to submittal. Applicant to include these pages into the construction plans as well as provide(2)separate 8-112"x 11" signed copies. PRIOR TO FINAL INSPECTION BY THE BUILDING DEPARTMENT,the green-point rater shall complete Column 3 and sign and Date section 2-Implementation Verification at the end of this cheddist and submit the completed form to the Building Department. COLUMN 2 COLUMN 3 MANDATORY FEATURE OR MEASURE Project Verification Requirements Rater to verify during Rater to initial construction as applicable measures applicable to project prior to submitting forms Plan" Qesi�ln site Development 4.106.2 A plan is developed and implemented to manage `n storm water drainage during construction. l' Pollutant.Control 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. n J 4.504.2.3 Aerosol paints and coatings shall be compliant with 'v rl 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. n 4.504.4 80 percent of floor area receiving resilient flooring shall `v comply with the VOC-emission limits defined in the Collaborative for High Performance Schools(CHPS) High Performance Products Database or be certified under the Resilient Floor Covering Institute (RFCI)FloorScore program;or meet California Dept.of Public Health,"Standard Method for the Testing and Evaluation of Volatile Organic Chemical Emissions from Indoor Sources Using Environmental Chambers",Version 1.1,February 2010(also known as Specification 01350. 4.504.5 Particleboard, medium density fiberboard(MDF)and +, hardwood plywood used in interior finish systems shall comply with N low formaldehyde emission standards. Interior Moisture 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. P4 1 Environmental Comfort 4.507.2 Duct systems are sized,designed,and equipment is selected using the following methods: ! ' 1. Establish heat loss and heat gain values according to ANSI/ rf ACCA 2 Manuel J-2004 or equivalent. �,••'� 2. Size duct systems according to ANSI/ACCA 1 Manual D-2009 or equivalent. 3. Select heating and cooling equipment according to ANSI/ACCA 3 Manual S-2004 orequivalent. l natallar and Agmial Inai w or Qualffl-caflom Qualifications 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 Special inspectors employed by the enforcing agency must be qualified and able to demonstrate competence in the discipline they are inspecting. Verifications 703.1 Verification of compliance with this code may include construction documents,plans,specifications builder or installer certification,inspection reports,or other methods acceptable to the enforcing agency which show substantial conformance 1. Green building measures listed in this table may be mandatory if adopted by a city, county,or city and county as specified in Section 101.7 2. Required prerequisite for this Tier. 3. These measures are currently required elsewhere in statute or in regulation 4.106.3 Construction plans shall indicate how site grading or a drainage system will manage all surface water flows to keep water from entering buildings. General 4.201.1 Building meets or exceeds the requirements of the California Building Energy Efficiency Standards3. j& of ftakway aim Conurrm9-0 Indoor Water Use 4.303.1. Plumbing fixtures(water closets and urinals)and fittings (faucets and showerheads)installed in residential buildings shall comply with the prescriptive requirements of Sections 4.303.1.1 L� through 4.303.1.4.4. '�J 4.303.2 Plumbing factures and fittings required in Section 4.303.1 shall be installed in accordance with the Califomia Plumbing Code, and shall meet the applicable referenced standards. ► Outdoor Water Use 4.304.1 Automatic irrigation systems controllers installed at the time of final inspection shall be weather or soil moisture-based. NktMM- MUMd ft" OO Ef ftIVA Enhanced Dumblifty and Reduced Maintenance 4.406.1 Annular spaces around pipes,electric cables,conduits or �` other openings in plates at exterior walls shall be protected 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 Rec On 4.408.1 Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with one of the following: 1. Comply with a more stringent local construction and demolition waste management ordinance;or 2. A construction waste management plan per Section 4.408.2;or 3. A waste management company per Section 4.408.3;or 4. The waste stream reduction alternative per Section 4.408.4. Building Maintenance and Operation 4.410.1 An operation and maintenance manual shall be provided to the building occupant or owner. EbLVIRQNMZNT Flee laces 4.503.1 Any installed gas fireplace shall be a direct-vent sealed- combustion type. Any installed woodstove or pellet stove shall comply with US EPA Phase II emission limits where applicable. VA Woodstoves,pellet stoves,fireplaces shall also comply with applicable local ordinances. UTILITY RELEASE REQUEST FORM 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•buildingo1cuoertino.org PURPOSE For residential single family or duplex construction,there are cases where gas and electric utilities are requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the building inspector, the City of Cupertino is allowing both utilities to be released prior to the final sign-off of the building. INSTRUCTIONS 1. Download this form at: http://v;mv.cupertino.or2/index.aspx?pa2e=297. 2. Complete the form and obtain signatures from both the owner of the property and the primary contractor. 3. Fax, E-Mail, Mail or hand deliver the original signed form to: City of Cupertino Building Division Attn: Utility Release Request Form 408-777-3228 office 10300 Torre Ave. 408-777-3333 fax Cupertino, CA 9,5014 buildingacu ertino.org 4. Schedule a Gas Meter Release inspection (4403) and/or Electric Meter Release inspection (9404). Please note, a Gas Test inspection (#506) is required prior to or at the same time of the Gas Meter Release inspection. BUILDING INFORMATION (Please complete the following information): APN � �Dn t BLDG PERMIT#: ` DATE:SITE ADDRESS: OWNER'S NAME' PHONE#: R-SV A RAM")/l FAX#: MAILING ADDRESS (if different from site address): l O 110 ' 14N N o COW^f'(IGO !"�T�"O FAX#E#: � S • �'L •I COcP�fL� - Pte; : 40$ I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of the building cannot move into the residence until they receive all of the required final sign-offs and the City has issued a certificate of occupancy for the b 'Idin . Owner:................... ....Print:.... ........Date:...... . .�..Ct.. ... Contractor:. ........................Print:..... ............. ...... '. . ..........................Date:...... ... . . . .. .. .... UtilitvReleaseForm 2011.doc revised 08/09/11 SimSan Jose Water San Jose Water Company Company Water Services Administration 1265 S.Bascom Ave.,San Jose,CA 95128 1265 S. Bascom Ave. Facsimile: 1 408 279-7889 San Jose,CA 95128-3514 Writer's Direct Dial: 1 408 279-7983 March 9, 2015 ZVEW RECEIVE11) MAR 11 2015 Shridar Subramanian 10405 Mann Drive Cupertino, CA._95014 B------- � 7 Ueyod- 4(p Reference: 10405 Mann Drive, Cupertino Dear Mr. Subramanian: The purpose of this letter is to inform you of the procedures you need to follow to finalize the installation of a new water service for this project. You will be required to hire a contractor to perform the service installation work to our standards and under our inspection. It is suggested, but not required, that you contact one of our general contractors to have this work performed. They are West Valley Construction at (408) 371-5510, and Lewis & Tibbitts at (408) 925-0220. In any case, your contractor must possess a valid license to perform this type of work, and must obtain a permit from the City of Cupertino to perform the work. Based on the data that was provided on our water service questionnaire, our Engineering Department has determined that a 1%" copper service with a check valve and pressure regulator is required for this house. The piping from the check valve/meter to the house should be 2" in size. By copy of this letter, we are informing the City of Cupertino of our determination, and I have enclosed our standard service drawing that details an approved installation. The meter/check valve (service connection) defines the point at which you receive service, and the point where the owner's piping begins. The owner of the property is responsible for all piping and equipment past the check valve. Please note that in addition to the check valve in the meter box, you must also install a rubber seated single check valve (property of the owner) on the internal plumbing of the house. The location of the check valve must be where the fire sprinkler piping tees off from the domestic piping. Also, the water pressure in this area is over 80 PSI. San Jose Water Company recommends that a pressure regulator be installed on private service lines that will prevent pressure in excess of 80 PSI from entering the structure. Please contact your plumber regarding this matter. 4 i • 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 S � (408)777-3228• FAX(408)777-3333•buildingQcupertino.org PURPOSE: ` ' - The 2013 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. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: 54112A6-12 x;0,61401, Jf ALIAA,�` A1-21921TI©Al Project Address: 1-04p.S d'Zaw doz , Project Description: ADZ)1A,6 4WF & a-bm. =WQp Q 3 Zgv, , Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. ,,p 2. The licensed professional, in collaboration with the owner andbe de�igri` rofessional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification'atthe e d of this checklist and have the checklist printed on the 1ppr9ved 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 Requirements . . .1 PLANNING AND DESIGNs t � ii n, and Desl<gnP Site Deve[opment 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during ❑X ❑ construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ® ❑ site grading or a drainage system will manage all surface water flows. Page 1 of 5 CalGreen_2014.doe revised 01/15/14 1 A4.2 ' 6eneraf 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. A4.3 WATER EFFICIENCY 1 CONSERVATION indoor Water Us+ 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals)and fittings (faucets and showerheads)shall comply with the following: ❑ 4.303.1.3.2 Water Closets.The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank-type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank-type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead,the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi,or the shower shall be designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen 2014.doe revised 01115114 Outdoor NNater Use 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather-based. ❑ 4.304.1.1 Controllers shall be weather-or soil moisture-based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ 4.304.1.2 Weather-based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture-based controllers are not required to have rain sensor input. A4.4 MATERIAL t Enhanced Or III and R;ed ce 11 me n x I 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. w Cc nstructlon Waste Reduc ion isposal and 4k, 4.408.2 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall be submitted for approval to the enforcing agency. Buildhng Maintenance and C3peratron T A 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building occupant or owner. . . .5 ENVIRONMENTAL QUALITY Al T laces 5 � 3 4.503.1 General. Install only a direct-vent sealed-combustion gas or sealed wood-burning fireplace, or a sealed woodstove. Pollutant Control 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air 0 distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic 0 compounds. Page 3 of 5 CalGreen_2014.doc revised 01/15/14 4.504.2.4 Verification. Documentation shall be provided to verify that , compliant VOC limit finish materials have been used. ® ❑ 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with ❑ VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) 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 ❑X ❑ Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall ❑X ❑ comply with low formaldehyde emission standards. InterldeMol'A'Urd�Gontrol� E '' 4.505.2 Concrete slab foundation. Required vapor retarders and capillary © ❑ breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building ® ❑ materials used in wall and floor framing is checked before enclosure. Indoor Alr Quality and exhaust' 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the © ❑ building are provided in every bathroom. 777 Ent' I Comfort 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. INSTALLER AND SPECIAL - QUALIFICATIONS Qualifications 702.1 Installer training. HVAC system installers are trained and certified in ® ❑ the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the X❑ ❑ discipline they inspect and verify. .Yerificatlons 703.1 Documentation. 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. Page 4 of 5 CalGreen_2014.doc revised 01115114 r Shridar Subramanian March 9, 2015 Page Two If you would like to proceed with the service work, please sign, date, and return the copy of this letter with a construction deposit as discussed below. Also include the address where the monthly billings should be sent. Monthly billings start when the meter is installed, and a copy of our rate schedule is enclosed for your information. You must also submit a deposit in the amount of $2,222.00 to cover the cost of our reviews and inspection, and the purchase and installation of the new meter, pressure regulator and check valve. Please make your check payable to San Jose Water Company. At the appropriate time, you will need to provide our Construction Department at least one week notice for inspection services. Your contact is Daryl Lambert, who can be reached at (408) 279-7830. A San Jose Water Company inspector must witness the actual tap of the water main. Once the service lateral and meter box have been installed and approved, we can install the meter and check valve at your request. If you have any questions, or require further information, please contact me at(408) 279- 7800, extension 5805. Sincerely, Jay Coito Water Services Representative JC:bt Enclosures FIP#15-030 cc: Building Department,City of Cupertino Richard Haro Drafting and Planning ACKNOWLEDGED AND AGREED MONTHLY BILLINGS TO: Responsible Party Name Signature Address Print Name City Date Phone Number CALGREEN SIGNATURE DECLARATIONS ,.,_. �._CtCS.IYt- ..,_C?��--.L2�Cl_�-�►�1 �_ qr� �e cae 1�n� Ki+ehf�n a�► K;�c hen e,����n5 re l4 ec,�dn� FAu t� wn fc SECTION DESIGN VERIFICATION C;fi JeCtiO'- . - esigl Veril cat,on­and ui is __>r piotUad cneckiist(c lu ns 1 a :,i a^ i ?L3 ifie F3UIlCairt^t��;^.cf;r _. ,. . _ n�ris>s �:nai reso, cnshe cor,nlian_.. .. -+( a.G: er Smrdards havere:ise_he utnom z_ :`'.2CKP B: GI•'e 8C?IlBfeC}'incort Orc?tu { !-.1. tle "f tl C n, t e d { C', plaans a. d kill be mple,� er ire°o ���e pit,' p r Gu reme�;ts set ert^in the Zliforr�ia Green, Build°r.g Standards. Come T . F { 1 A `f Lc,+ r� IN 2 - IMPLEMENTATION VERIFICATION `..i;?i''-lt`: ::1'n(JetG'dli2CK)lSi. 1tli�ll dl^ij c,)iUilm 3,together v,,!h all oris final signatures o1'. S@Ctior! or to 3LIi'dlrtg Deoazrtment '^a7F C44n„ Y: F ave,eresV8d ;t+do_u rr,F`.`.ation `o;/erif a,r,:Ce;t!N 4 hal the.DrGjG'Ct iden6 e ;G'ja ,. .o-+, itl.S G:Gs!)3 1:,+ *he kl'st ...0 .l accordance wi'h`he rein! i bre_n :'=i.Acim Standards i..tjCe ai adoc te''i.1v ti C;fy of CLireruno. Y i t