13060067 (2) CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1255 POPPY WAY CONTRACTOR:OMEGA CONSTRUCTION PERMIT NO: 13060067
OWNER'S NAME: HSUEH NAOMI H AND WEN-CHUNG 451 FENLEY AVE DATE ISSUED:07/15/2013
OWNER'S PHONE: 4088582151 SAN JOSE,CA 95117 PHONE NO:(408)243-0404
❑ LICENSED CONTRACTOR'S DECLARATIONJOB DESCRIPTION: RESIDENTIAL 1-JCOMMERCIALE]
License Class Lic.# Q , CONSTRUCT A DETACHED 2ND DWELLING UNIT(409 SQ
Contractor Date � 13
)
I hereby affirm that I am licensed under the provisions of hapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$75000
l 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:36618017.00 Occupancy Type:
permit is issued. p y
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 LASE" LLED 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 Issu y: ate:
with all non-point source regulatio rtmo Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date 6 All roofs shall be inspected prior to any roofing material being installed. if a roof is
installed without first obtaining an inspection,1 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
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 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(x)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this 7
permit is issued. Owner or authorized agent: D
1 certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,1 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 1 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
KJ�
CONSTRUCTION PERMIT APPLICATION pO
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �b
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•building(a,cupertino.org
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/T1 ❑ REVISION/DEFERRED ORIGINAL PERMIT N
PROJECT ADDRESS ( 5 APN 0 / /ti` 7
OWNS C Lo PHO744_ ,ry �� E-MAIL `k-S�eH
STREET ADDRESS D CITY, STATE,ZIP _,`e ` FAX
CONTACT NAME PHO1�L/�-` W ,Y E-MAIL/�r �6
STREET ADDRESS r tw z r CITY,STATE,ZIP
J &7c-)
64 D ) 1 FFAXG/v
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑(CONTRACTOR ❑CONTRACTOR AGENT A ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Jt; LICENSE NUMBER LICENSE TYPE BUS.LIC 0
COMPANY NAME ��// E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER /� BUS.LIC 0
COMPANYNAME�� U y l •MAILCCI�y �` (�, FAX ff U
STREET ADDRESS /naa LZ CITY,ST TE Z ) q
DESCRIPTION OF WORKaNir - W!CJ) a�E Cf5WA(� J [ J`( j!�(
V
Qi
EXISTING USE PROPOSED USE CONSTR TYPE 0 STORIES
,Q E PeA 1 C I /)Zr►ar� "ST►I 1 USE TYPE OCC. SQ.FT. VALUATION(S)
EXI/STTGG,', q/jq� NEW FLOOR CSI/1//�DCE•MO �VTOTAL
AREA AREA :f0 AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECKJPORCH AREA GARAGE AREA: DETACH
[]ATTACH
0 DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? ❑NO ADDITION? ❑NO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIV TgTAL VALUATIO
PLANNNGAPPLO []NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO _ f �-. o0
-\ YY((( 'irJ v
By my signature below,1 certify to each of the following: I am the property owner or authorized a to t on the-property owne`r's behalf l have read this
application and the information I have provided rrect. I ead the Description of Wor nd verify'i�curate. I agree to comply with all applicable local,
ordinances and state laws relating to buildin ction. a representatives of Cupertino to enter the above-identifiejd property for inspection purposes.
Signature of Applicant/Agent: Date: l`
SUPPLEMENTAL INFORMATION REQUItED PLAN CHECK TYPE ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-TILE-COUNTER ❑ BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. F 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 of this project. ❑ LARGE ❑ FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 1255 POPPY WAY DATE: 06/10/2013 REVIEWED BY: MELISSA
AP 366 18 017 BP#: VALUATION: $75,000
-PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction
PRIMARY SFD or Duplex 2nd Unit? `,Yes No PENTAMATION
USE: PERMIT TYPE:
WORK [Aqq-N) DETACHED 2ND UNIT 409 S.F. IN REAR YARD OF E SFD
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.L
R-3 (Custom) II-B,111-B,IV,V-B 409 $2,468.00 IR3PLNCK $1,549.00 IR3INSP
TOTALS: 409 $2,468.00 $1,549.00
Mcch. Plan Elec.flan Check
Mech, Permit Plumb. Permit Fee: Elec. Permit Fee.
Other,ifech. Insp. Other Plumb Insp. Other Elec.Insp. Li
He&Insp.Fee: Plurnh Insp. Fee: Elec. Insp.Fee:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works, Fire,Sanitary Sewer District,School
District eta). These fees are based on the prelimin in ornwion available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-033 E . 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,468.00 Select a Misc Bldg/Structure
Suppl. PC Fee: (j) Reg. Q OT 0.0 rsrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $1,549.00
Suppl. Insp.Fee-0 Reg. Q OT 0.0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
#new
Construction Tax: IBCONSTAXR 1 units $641.96
AdministrativeFee:
Work Without Permit? Yes Q No $0.00 E)
Advanced Planning Fee. IPLLONCR $53.17 Select a Non-Residential E)
Travel Doewnentatiun Fees: Building or Structure 0
i
Strom Motion Fee: IBSEISMICR $7.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $3.00
SUBTOTALS: $4,722.63 $0.00 TOTAL FEE: $4,722.63
" Revised: 04/29/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: PERMIT#
OWNER'S NAME: ►° PHONE #
GENERAL CONTRACTOR: BUSINESS LICENSE# 2
ADDRESS: — 74 CITY/ZIPCODE:
*Our municipal ode requires all busi esses 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 H RTAINED 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
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum/Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting /Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
0wner/ n ract ig e
2010 CALGREEN RESIDENTIAL CHECKLIST —
MANDATORY ITEMS
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVI , N
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 ICE COPY
(408)777-3228• FAX(408)777-3333- buildinq(@cupertino.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. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the
requirements of CALGreen.
Project Name: Hsueh Residence (2nd unit)
Project Address: 1255 Poppy Way, Cupertino, CA CUPERTINO
Building Beparbnunr
Project Description: New 2nd unit in the existing single : esidence
JUN 2 8 201
Instructions: REVIEWED FOR CODE COMPLIANCE
1. The Owner or the Owner's agent shall employ a licensed professional expenenMywith-Cfie 201 ff6(nia
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 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
4.106.2 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 ❑X ❑
system will manage all surface water flows.
Pagel of 5 Ca[Green_2010.doc revised 08/27/11
1
A4.2
General
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 AND 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.
0 ❑
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
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 I • • 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 ❑ ❑
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
4.408.2 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 ❑ El
occupant or owner.
Page 2 of 5 ColGreen_2010.doc revised 08/27/11
ENVIRONMENTAL
Fireplaces
4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- ❑
burning fireplace, or a sealed woodstove.
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. ❑X ❑
4.504.2.3 Aerosol paints and other coatings shall be compliant with product ❑X ❑
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. ❑X ❑
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(CHIPS) 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 ❑X ❑
emission standards.
Interior Moisture Control
4.505.2 Vapor retarder and capillary break is installed at slab on grade
foundations. XD ❑
4.505.3 Moisture content of building materials used in wall and floor framing is ❑
checked before enclosure.
Page 3 of 5 CalGreerr_2010.doe 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 fan is off. Covers or louvers shall have a minimum QX
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.
INSTALLER 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 QX
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.
Page 4 of 5 Ca/Green_2010.doe revised 08127111
CALCREEN SIGNATURE DECLARATIONS
Project Name. Hsueh Residence (2nd unit)
Protect Address 1255 Poppy VVay, Cupertino, CA
Project Description: New 2nd unit in the existing single family residence
SECTION I - DESIGN VERIFICATION �
Gomp:ei.e a�. ,ir es of seC`'on 1 - �xs,y 'vE,r � v unn no=cewd CheCkhSt: �. n5 . 2no K; y th it
pans and h_ tmg per,r:it appikahon to ne Pi. D p_
_ lr
The OWner 2nd design professional resp n siz,! fcr .�! a .t ca J oe , SandaMs have d ,r C N;arls._Ono
cat y that he I ens t:heNed above are h.a.,eti} i t ; _ and b N be i �( emented Am te,
prefect in accorcance wi i ,.e requiren en is Set ! We _0 0 Mama �; E'. Eufldin.i Si3i'S Code d3
0,e
adapted by the City of Cper.1no
06125;2013
;�..ner s Slgn;l re ' Date
Wen - Chung Keh
owner s N e !P!.ease
l:es?gn F''roiessional's Signature Cate
Design Pro°-_s ai s ttian= Pr;n°}
SQnaWre of License Professional @" 5^s ble Qr Ca Gree „ anc2
Name cf License Professional res 'onsibie for CaiGreen compliance(Please Print) Phone
Final P ddre-s for License P(ofessional reFponsibie for C:a Green compliance
I
SECTION 2 - IMPLEMENTATION VERIFICATION
Complete, sign and submit ;ne::ore:eted cher ,v- Ir. -.,�.ng wumn 3 tc rhe titi.th = r„.nt;,signatures on Se:aian
x to the Building Department prior i0,B` j-ilding rjral inspect on
I ha`de .'S—rk `h '` .,._
e work vi` � � mentaten r .'eMy'and i:r ih,3 WGS�f eW
We de'i:.':ad
2DOL`e:Sa$ Ir tiny if'amp 'ice won As Goan B 'Airg CnecKi m a mo in accordance ,.rlih Me requirernenis of
0 2410 filayCB Wwwa`Cs Code a5 adocted L:v me City cf Cupertino.
I
f
jlgnai I01 L.,CenSe'ProfeSSlonal re5l::li iasv�c`:^.(C:a;l3ree�+;,Ot'?:;ila!lCC Date
Eric Keng (6 g)32'-2508
_ ...
Naa)e Of License Professiotnai iesponsibie for Cat Gteen cDmpl ancE t Please i=rani; Phone _
erickeng@eihorne.com
Ernaii Address for License Professional respons bie for CaiGreen c:m anise
BUILDING ENERGY ANALYSIS REPORT
PROJECT:
Hsueh Residence
1255 Poppy Way
Cupertino, CA 95014
Project Designer:
DL Architecture and Planning
616 Ramona Street #21
Palo Alto, Ca
650-321-2808
Report Prepared by:
Jam Hezar, J.D. LEED-AP
Alliance 24 Title
140 "B" Street Suite 5-276
Davis, CA 95616
(530) 902-4387
CUPERTINO
d
Building Depaliment Job Number:
JUN 21 2013
13-06104
REVIEWED FOR CODE COMPLIANCE Date:
Reviewed By. h7 'W/
6/24/2013
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report.This program has approval and is
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC—www.energysoft.corn.
Ener Pro 5.1 by Ener Soft User Number:6262 RunCode:2013-06-24715:07:29 ID:13-06104
TABLE OF CONTENTS
Cover Page 1
Table of Contents 2
Form CF-1 R Certificate of Compliance 3
Form MF-1 R Mandatory Measures Summary 8
HVAC System Heating and Cooling Loads Summary 11
EnergyPro 5.1 by EnergySoft Job Number: ID:13-06104 User Number:6262
PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-1 R
Project Name Building Type m Single Family ❑ Addition Alone Date
Hsueh Residence ❑ Multi Family ❑ Existing+Addition/Alteration 7612412013
Project Address California Energy Climate Zone Total Cond. Floor Area Addition 4 of Stories
1255 Poppy Way Cupertino CA Climate Zone 04 409 n/a 1
FIELD INSPECTION ENERGY CHECKLIST
❑ Yes El No HERS Measures -- If Yes, A CF-4R must be provided per Part 2 of 5 of this form.
El Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details.
INSULATION Area Special
Construction Type Cavity (ft) Features see Part 2 of 5 Status
Wall Wood Framed R-15 641 New
Door Opaque Door None 20 New
Roof Wood Framed Rafter R-30 401 New
Slab Unheated Slab-on-Grade R-5 409 Perim=89' New
FENESTRATION U- Exterior
Orientation Area fig) Factor SHGC Overhang Sidef ins Shades Status
Front(N) 20.0 0.340 0.31 none none Bug Screen New
Right(tM 17.5 0.300 0.28 none none Bug Screen New
Rear(S) 20.0 0.300 0.28 none none Bug Screen New
Skylight 8.0 0.500 0.50 none none None New
HVAC SYSTEMS
Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status
1 Room Heat Pump 3.50 COP No Cooling 13.0 SEER Setback New
HVAC DISTRIBUTION Duct
Location Heating Cooling Duct Location R-Value Status
Wall Furnace PTHP Ductless/No Fan Ductless n/a nla New
WATER HEATING
Qty. Type Gallons Min. Eff Distribution Status
1 Instant Gas 0 0.85 Kitchen Pipe Ins New
Ener Pro 5.1 by EneTySoft User Number.,6262 RunCode:2013-06-24T15:07:29 ID:13-06104 Page 3 of 11
PERFORMANCE CERTIFICATE: Residential Part 2 of 5 CF-1 R
Project Name Building Type m Single Family ❑ Addition Alone Date
Hsueh Residence ❑ Multi Family ❑ Existing+Addition/Alteration 6/24/2013
SPECIAL FEATURES INSPECTION CHECKLIST
The enforcement agency should pay special attention to the items specified in this checklist.These items require special written
justification and documentation,and special verification to be used with the performance approach. The enforcement agency
determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of
the special justification and documentation submitted.
The HVAC System Wall PTHP does not include a cooling system, field verification is not necessary.
HERS REQUIRED VERIFICATION
Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a
completed CF-4R form for each of the measures listed below for final to be given.
Ener Pro 5.1 by Ener Soft User Number:6262 RunCode:2013-06-24715:07:29 /D:13-06104 Page 4 of 11
PERFORMANCE CERTIFICATE: Residential Part 3 of 5 CF-1 R
Project Name Building Type m Single Family ❑ Addition Alone Date
Hsueh Residence ❑ Multi Family ❑ Existing+ Addition/Alteration 6/24/2013
ANNUAL ENERGY USE SUMMARY
Standard Proposed Margin
TDV kBtu/ft2- r
Space Heating 21.87 11.59 10.28
Space Cooling 15.11 16.73 -1.61
Fans 5.86 6.29 -0.42
Domestic Hot Water 59.11 32.11 27.00
Pumps 0.00 0.00 0.00
Totals 101.95 66.71 35.25
Percent Better Than Standard: 34.6%
BUILDING COMPLIES - NO HERS VERIFICATION REQUIRED
Fenestration
Building Front Orientation: (N)0deg Ext. Walls/Roof Wall Area Area
Number of Dwelling Units: 1.00 (N) 110 20
Fuel Available at Site: Natural Gas (E) 252 0
Raised Floor Area: 0 (S) 104 20
Slab on Grade Area: 409 (w) 252 18
Average Ceiling Height: 8.0 Root 409 8
Fenestration Average U-Factor: 0.31 TOTAL: 66
Average SHGC: 0.29 Fenestration/CFA Ratio: 16.0%
REMARKS
STATEMENT OF COMPLIANCE
This certificate of compliance lists the building features and specifications needed �fiDLl, Meer
to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the mmmal"M
Efficiency Standards of the California Code of Regulations. "''°'
The documentation author hereby certifies that the documentation is accurate and complete.
Documentation Author
Company Alliance 24 Title
�612412013
Address 140"B"Street Suite 5-276 Name Jam Hezar,J.D. LEED-AP
City/State/ZipCity/State/Zip Davis, CA 95616 Phone (530)902-4387 ned Date
The individual with overall design responsibility hereby certifies that the prop uilding design represented in this set
of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and
with any other calculations submitted with this permit application, and recognizes that compliance using duct design,
duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require
installer testing and certification and field verification by an approved HERS rater.
Designer or Owner (per Business & Professions Code)
Company DL Architecture and Planning
Address 616 Ramona Street#21 Name Eric Keng
City/State/Zip Palo Alto, Ca Phone 650-321-2808 Signed Li nse# Date
Ener Pro 5.1 by EnerqySoft User Number.-6262 RunCode:2013-06-24715:07:29 /D:13-06104 —Fia--V 5 o 11
CERTIFICATE OF COMPLIANCE: Residential Part 4 of 5 CF-1 R
Project Name Building Type m Single Family ❑ Addition Alone Date
Hsueh Residence ❑ Multi Family ❑ Existing+Addition/Alteration 612412013
OPAQUE SURFACE DETAILS
Surface Ll- Insulation Joint Appendix
Type Area Factor Cavit Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
Wall 70 0.095 R-15 0 90 New 4.3.1-A4 Floor
Door 20 0.500 None 0 90 New 4.5.1-A4 Floor
Wall 235 0.095 R-15 2701 90 New 14.3.1-A4 Floor
Wall 252 0.095 R-15 90 90 New 14.3.1-A4 Floor
Wall 84 0.095 R-15 180 90 New 4.3.1-A4 Floor
Roof 401 0.035 R-30 0 0 New 4.2.2-A 17 Floor
Slab 409 0.720 R-5 0 180 New 4.4.7-B2 Floor
FENESTRATION SURFACE DETAILS
ID Type Area LI-Factor SHGC Azm Status Glazing Type Location/Comments
1 Window 20.0 0.340 NFRC 0.31 NFRC 0 New Window Floor
2 Window 17.5 0.300 NFRC 0.28 NFRC 270 New Window— Floor
3 Window 20.0 0.300 NFRC 0.28 NFRC 180 New Window— Floor
4 Skylight 8.0 0.500 NFRC 0.50 NFRC 0 New Skylight Floor
(1) U-Factor Type: 116-A=Default Table from Standards,NFRC=Labeled Value
2 SHGC Type: 116-13=Default Table from Standards,NFRC=Labeled Value
EXTERIOR SHADING DETAILS
Window Ove hang Left Fin Right Fin
ID Exterior Shade Type SHGC H t Wd Len H t LExt RExt Dist Len H t Dist Len I Hat
1 Bug Screen 0.76
2 Bug Screen 0.76
3 Bug Screen 0.76
4 None 1.00
Ener Pro 5.1 by EnergySoft User Number.,6262 RunCode:2013-06-24715:07:29 ID: 13-06104 Pae 6 of 11
CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5 CF-1 R
Project Name Building Type ❑ Single Family ❑ Addition Alone Date
Hsueh Residence ❑ Multi Family ❑ Existing+Addition/Alteration 6/24/2013
BUILDING ZONE INFORMATION
Floor Area ft
System Name Zone Name New Existing Altered Removed Volume Year Built
Wall Furnace PTHP Floor 409 3,272
Totals 409 0 01 0
HVAC SYSTEMS
System Name Qty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status
Wall Furnace PTHP 1 Room Heat Pump 3.50 COP No Cooling 13.0 SEER Setback New
HVAC DISTRIBUTION
Duct Ducts
System Name Heating Coolin Duct Location R-Value Tested? Status
Wall Furnace PTHP Ductless/No Fan Ductless n/a n/a ❑ New
WATER HEATING SYSTEMS
Ext.
Rated Tank Energy Standby Tank
Input Cap. Factor Loss or Insul. R-
S stem Name Qty Type Distribution Btuh al or RE Pinot _Value Status
TAKAGI T-K2 1 Instant Gas Kitchen Pipe Ins 175,000 0 0.85 n/a n/a New
MULTI-FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING
Hot Water Piping Length
ft o
cn
Pipe Pipe Insul.
Control Qty. HP Plenum Outside Buried ¢ — System Name Len th Diameter Thick.
❑
13
EnergyPro 5.1 by Ener Soft User Number:6262 RunCode:2013-06-24T15:07:29 ID:13-06104 Page 7 of 11
MANDATORY MEASURES SUMMARY: Residential (Page 1 of 3 MF-1 R
Project Name Date
Hsueh Residence 6/24/2013
NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of
the compliance approach used. More stringent energy measures listed on the Certificate of Compliance(CF-1 R, CF-1 R-ADD,or CF-
1 R-ALT Form)shall supersede the items marked with an asterisk (*) below. This Mandatory Measures Summary shall be incorporated
into the permit documents, and the applicable features shall be considered by all parties as minimum component performance
specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF-1 R
Form with plans.
Building Envelope Measures:
116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage.
§1 16(a)4: Fenestration products (except field-fabricated windows) have a label listing the certified U-Factor,certified Solar Heat Gain
Coefficient SHGC , and infiltration that meets the requirements of 10-111(a).
117:Exterior doors and windows are weather-stripped;all joints and penetrations are caulked and sealed.
118(a): Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF-6R Form.
§1 18(i):The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of§118(i)when the
installation of a Cool Roof is specified on the CF-1 R Form.
*§1 50 a :Minimum R-19 insulation in wood-frame ceiling orequivalent U-factor.
150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R-Value.
*§1 50 c : Minimum R-13 insulation in wood-frame wall orequivalent U-factor.
*§1 50 d :Minimum R-13 insulation in raised wood-frame floor orequivalent U-factor.
150(f):Air retarding wrap is tested, labeled,and installed according to ASTM Ell 677-95(2000)when specified on the CF-1 R Form.
150 : Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§150(1):Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%;water vapor permeance
rate is no qreater than 2.0 perryVinch and shall be protected from physical damage and UV light deterioration.
Fireplaces, Decorative Gas Appliances and Gas Log Measures:
150 e 1A: Masonry or factory-built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)1 B: Masonry or factory-built fireplaces have a combustion outside air intake,which is at least six square inches in area and is
equipped with a with a readily accessible, operable, and tight-fifting tight-fittingdamper and or a combustion-air control device.
§150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket,when that indoor air is vented to the
outside of the building,are prohibited.
Space Conditioning, Water Heating and Plumbing System Measures:
§110-§113: HVAC equipment,water heaters,showerheads,faucets and all other regulated appliances are certified by the Energy
Commission.
§113(c)5:Water heating recirculation loops serving multiple dwelling units and High-Rise residential occupancies meet the air release
valve backflow prevention, pump isolation valve, and recirculation loop connection requirements of§113(c)5.
§115: Continuously burning pilot lights are prohibited for natural gas:fan-type central furnaces, household cooking appliances
(appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and
spa heaters.
150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
150(i):Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c).
§150(j)1A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped
with insulation having an installed thermal resistance of R-12 or greater.
§150(j)1 B: Unfired storage tanks,such as storage tanks or backup tanks for solar water-heating system, or other indirect hot water
tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R-value is indicated on the exterior of the
tank.
§150(j)2: First 5 feet of hot and cold water pipes closest to water heater tank, non-recirculating systems, and entire length of
recirculating sections of hot water pipes are insulated per Standards Table 150-B.
§1500)2:Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot
water tank shall be insulated to Table 150-B and Equation 150-A.
§150(j)2: Pipe insulation for steam hydronic heating systems or hot water systems>15 psi, meets the requirements of Standards Table
123-A.
150(j)3A: Insulation is protected from damage, includinq that due to sunlight, moisture, equipment maintenance, and wind.
§150(j)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in
conditioned space.
150(j)4:Solar water-heating systems and/or collectors are certified by the Solar Rating and Certification Corporation.
EnergyPro 5.1 by EnergySoft User Number:6262 RunCode:2013-06-24715:07:29 ID:13-06104 Page 8 of 11
'MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF-1 R
Project Name Date
Hsueh Residence 6/24/2013
§150(m)1:All air-distribution system ducts and plenums installed,are sealed and insulated to meet the requirements of CMC Sections
601, 602, 603, 604, 605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-
4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct-closure system that meets the
applicable requirements of UL 181, UL 181 A,or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is
used to seal openings reater than 1/4 inch, the combination of mastic and either mesh or tape shall be used
§150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed
sheet metal,duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may
contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area
of the ducts.
§150(m)2D:Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes
unless such tape is used in combination with mastic and draw bands.
150(m)7: Exhaust fans stems have back draft or automatic dampers.
§150(m)8:Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated
dampers.
§150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture,equipment maintenance,and wind.
Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar
radiation that can cause degradation of the material.
150 m 10: Flexible ducts cannot have porous inner cores.
§150(o):All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air
Quality in Low-Rise Residential Buildings.Window operation is not a permissible method of providing the Whole Building Ventilation
required in Section 4 of that Standard.
Pool and Spa Heating Systems and Equipment Measures:
§114(a):Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency
Regulations;an on-off switch mounted outside of the heater;a permanent weatherproof plate or card with operating instructions;and
shall not use electric resistance heating ora pilot light.
§114(b)1: Any pool or spa heating equipment shall be installed with at least 36"of pipe between filter and heater,or dedicated suction
and return lines, or built-up connections for future solar heating.
114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover.
§114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or
programmed to run only during off-peak electric demand periods.
150 : Residential pool systems orequipment meet the pump sizing,flow rate, piping,filters,and valve requirements of§150
Residential Lighting Measures:
§150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies
contained in Table 150-C and is not a low eff icacy luminaire asspecified by§150(k)2.
150(k)3:The wattage of permanently installed luminaires shall be determined asspecified by§130(d).
§150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than
20 kHz.
§150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain
only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line-voltage socket or line-
voltage lamp holder;OR shall be rated to consume no more than five watts of power as determined by§130(d), and shall not contain a
medium screw-base socket.
150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens,shall meet the applicable requirements of§150(k).
150(k)7:All switching devices and controls shall meet the requirements of§150(k)7.
§150(k)8:A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy.
EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be
exempt from the 50%high efficacy requirement when:all low efficacy luminaires in the kitchen are controlled by a manual on occupant
sensor,dimmer, energy management system(EMCS), or a multi-scene programmable control system;and all permanently installed
luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a
manual-on occupant sensor.
§150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of
illuminated cabinet.
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MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF-1 R
Project Name Date
Hsueh Residence 6/24/2013
§150(k)l0:Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms
shall be high efficacy.
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual-on
occupant sensor certified to comply with the applicable requirements of§119.
EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a
manual-on occupancy sensor.
§150(k)11: Permanently installed luminaires located in rooms or areas other than in kitchens,bathrooms,garages, laundry rooms,
closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be
allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of§119, or by a manual-
on occupant sensor that complies with the applicable requirements of§119. EXCEPTION 2: Lighting in detached storage building less
than 1000 square feet located on a residential site is not required to comply with §150 k 11.
§150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters
Laboratories or other nationally recognized testing/rating laboratory;and have a label that certifies the lumiunaire is airtight with air
leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283;and be sealed with a gasket or caulk between
the luminaire housing and ceiling.
§150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more
dwelling units, entrances, balconies, and porches,which are permanently mounted to a residential building or to other buildings on the
same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that
they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor,
and one of the following controls:a photocontrol not having an override or bypass switch that disables the photocontrol;OR an
astronomical time clock not having an override or bypass switch that disables the astronomical time clock;OR an energy management
control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2:Outdoor
luminaires used to comply with Exceptionl to§150(k)13 may be controlled by a temporary override switch which bypasses the motion
sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed
luminaires in or around swimming pool,water features,or other location subject to Article 680 of the California Electric Code need not
be high efficacy luminaires.
§150(k)14: Internally illuminated address signs shall comply with Section 148;OR not contain a screw-base socket,and consume no
more than five watts of power as determined according to §130(d).
§150(k)l5: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable
requirements in Sections 130, 132, 134,and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable
requirements of Sections 130 131, 134, and 146.
§150(k)16: Permanently installed lighting in the enclosed, non-dwelling spaces of low-rise residential buildings with four or more
dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided
that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119.
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-HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
Project Name Date
Hsueh Residence 6/24/2013
System Name Floor Area
Wall Furnace PTHP 409
ENGINEERING CHECKS SYSTEM LOAD
Number of Systems 1 COIL COOLING PEAK COIL HTG. PEAK
Heating System CFM Sensible Latent CFM Sensible
Output per System 13,100 Total Room Loads 219 5,437 590 189 8,129
Total Output(Btuh) 13,100 Return Vented Lighting 0
Output Btuh/s ft 32.0 Return Air Ducts 0 0
Cooling System Return Fan 0 0
Output per System 0 Ventilation 0 0 0 0 0
Total Output Btuh 0 Supply Fan 0 0
Total Output ons 0.0 Supply Air Ducts 0 0
Total Output Btuh/s ft 0.0
Total Output s ftrron 0.0 TOTAL SYSTEM LOAD 1 5,437 590 8,129
Air System
CFM per System 1,000 HVAC EQUIPMENT SELECTION
Airflow cfm 1,000 Wall PTHP 0 0 8,633
Airflow cfm/s ft 2A4
Airflow cfm/Ton 0.0
Outside Air % 0.0% Total Adjusted System Output 0 0 8,633
Outside Air cfm/s ft 0.00 (Adjusted for Peak Design conditions)
Note:values above given at ARI conditions TIME OF SYSTEM PEAK Aug 3 PM Jan 1 AM
HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak
28 OF 70 OF 1c)
f'
Outside Air
0 cfm Heating Coil Supply Fan
110 OF
1,000 cfm nn
RV
70 IF 70 OF
COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak
8$/68°j 78/62°F 55/54°F 55/54°F
E
k
Outside Air 0
0 cfm Cooling Coil Supply Fan 55/54 OF
1,000 cfm
41.1 % ROM a
?8/62°F 78/62
EnergyPro 5.1 by EnergySoft User Number-6262 RunCode:2013-06-24T15:07:29 /D: 13-06104 Page 11 of 11
2010 CALGREEN RESIDENTIAL CHECKLIST — I L E
MANDATORY ITEMS
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ! 0
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 aacupertino.om
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. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the
requirements of CALGreen.
Project Name: Hsueh Residence (2nd unit)
Project Address: 1255 Poppy Way, Cupertino, CA
Project Description-. New 2nd unit in the existing single family residence
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 VLrification 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
PLANNINGr 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 0 ❑
minimize future adverse effects on the proposed structure.
Planning and Design -Site Development
4.106.2 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 0 ❑
system will manage all surface water flows.
Page I of 5 CalGreen_2010.doc revised 08/27111
A4.2
General
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 AND CONSERVATION
Indoor Water Use
4.303.1 Indoor water use shall be reduced by at least 20 percent using one of
the follow methods.
❑X ❑
❑ Water saving fixtures or flow restrictors shall be used per Table 4.303.2.
1:1A 20 percent reduction in baseline water use shall be demonstrated per As of 710112011
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
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 EFFICIENCY
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
against the passage of rodents by closing such openings with cement mortar, El
concrete masonry or similar method acceptable to the enforcing agency.
Construction Waste Reduction, Disposal and Recycling
4.408.2 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.
Page 2 of 5 CalGreen_2010.doc revised 08/27/11
A4.5
ENVIRONMENTAL
1 QUALITY
Fireplaces
4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- ❑ ❑
burning fireplace, or a sealed woodstove.
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. ❑X ❑
4.504.2.3 Aerosol paints and other coatings shall be compliant with product ❑X ❑
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. ❑X ❑
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 ❑X ❑
emission standards.
Interior Moisture Control
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.
Page 3 of 5 CalGreen_2010.doc revised 08127/11
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 fan 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.
INSTALLER AND SPEQUALIFICATIONS
CIAL INSPECTOR
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 OX
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.
Page 4 of 5 CalGreen_2010.doc revised 08/27/11
CALGREEN SIGNATURE DECLARATIONS
Project Names Hsueh Residence (2nd unit)
Project Address. 1255 Poppy Way, Cupertino, CA
Project Descriptiom New 2nd unit in the existing single family residence
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 ofper
C `no.
C4�/� 0612512013
Owner's Signature Date
Wen - ChungLeh_
Owner's N lease Pri
A
2 i �
Design Professional's Signature Date
Design Pro s al's Na Print)
bGz� f�
Signature of License Professional re nsible for CalGreen compliance Date
1-111L KM 6 o
Name of License Professional rejonsible for CalGreen compliance(Please Print) Phone
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 inspecte he work a received sufficient documentation to verify and certify that the project identified
above was c truCted in accoLq6nce with this Green Building Checklist and in accordance with the requirements of
the 2010 if is Ghee i tandards Code as adopted by the City of Cupertino.
06/24/2013
Signature of License Professional respo le for CalGreen compliance Date
Eric Keng (650)321-2808
Name of License Professional responsible for CalGreen compliance(Please Print) Phone
erickeng@elhome.com
Email Address for License Professional responsible for CalGreen compliance
Page 5 of 5 CalGreen_2010.doc revised 08 2?11