08070010 CITY OF CUPERTINO •t* +�« .'axiom 1 z ^"
BUILDING DIVISPON—— _ PERMIT C,ONTRACTOR'%Il (}HMATI -
BUI TNG ADDRESS: PERMIT NO.
0461. GLENVIEW AVE TBD — TO BE DETERMINED 08070010
OWNER'S NAME: PERMIT WOE DATE
L,OGHS GRINYASAN 07/01/2008
ONE SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
-BLDG ELECT PLUMB MECH
0
u00 LICENSED CONTRACTOR'S DECLARATION Job Description
rd ted F I herby affirm that 1 am limnsod under provisions of Chapter 9(commencing p
with Scaion 7IXXI)ofDivision]of tho Businea and Pro(cssiom Code,and mylicena is ADD A/C 3 TONS
_' „ k ren rame.nd err Lia g f�g 503 S
' c D�naclaa^ _o Contractor PACIFIC SERVICE PD FOR BUS LIC 7/1/8
e uy� ARCHITECTS DECLARATION
< 1 understand my phots shall he used as Public rmmrdl
g�
G Licensed Prufcssional
MMM OWNER-BUILDER DECLARATION
I f I hereby mnrm that 1 am exempt from the Contrition,Litems Law fat the
C e O following mann.(Section 7(D 1.5,Business and Proreaionl Code:Any city at county
S q which requires a Permit to construct,alter.improve,demolish.or repair my structure
poor to its issuance.also requires the applicant for such Permit o rile a signed statement
S< Rm he is licensed pursuant in tan provisions of the Cnmmctans License Law(faapur9 Sq.Ft.Floor Area Valuation
xk- (commencing with Section 70M)of Division 3 of the,Business=it Professions Code)m $4400
y $
that he Is attempt Rwe(mn and the basis for the alleged exemption.My violation of
Suction 7031.5 by airy applicant for a permit subjects the applicant at a civil Penalty of Number Occupancy Type
not mon than five handled dollars(S50n 36911033 . P Y YP
Idea w or .and pro(vty,amyemployw or offered wage udu'vakcompensn
wad da the work dna R-,wares ds tors skeetded orwr rorsakpply t oan OwnrBusiness
and property
obu l&or The Camtantot,and
Law dans Out apply lf an rwmr of Required Inspections
properlywhobuildsviid thavu thereon,dnawho an,not ihwork h reffredResal hu
Own emplayml,presided Rat such impmvem within
an not intended of c maR-rcd Resale If.
builder.Na Wildingorimprovement g sold edidnaneyeti or completion.Re owe of
builder will have the WNm of proving Rat he aid not build m improae for purpose ar
ale.).
❑1,as an-mer of the property,aro excluivcly conuscsing with licensed remand!,to
ixedsrrmt the project(Sec.7044.Busivusl and Professiotu Cade:)The Cormacbns LL
ecus law does am apply to an Manor of propmy who builds or improves Rercer.and
whocomac s fes,such projects whh aeownetor(s)licensed .at to the Cmenecto'a
Licmue law.
❑l am exempt under See ,B&PC far this moon
owner Date
WORKER'S COMPENSATION DECLARATION
I hereby afrure under penalty of pedury am or the fallowing decimations,
have and will maintain a CertiOam afConsen,w xlf-buure for Worker's Comport.
Gaon.as presided far by Session 3700 of the Labor Code.far the pertomame of the
work for which this permit is issued.
❑1 bare and will chairman Worker's Compensation lomnnce,as required by Section
3700 of the Latour Code,for Re pcoormance of the work for which this permit is issued.
My Werke aCompen tion lnsunnceamdwand Poldcynumberare:
Cartier. Policy No.:
CERTIFICATE OF EXEMPRON FROM WORKERS'
COMPENSATION INSURANCE
(This sectim need methecomplesd if the Permit is foram hundred duBars(5100)
or less)
1 cutiry that in the pefromame of the work for which this panni,is istmd,I s1Wl am
employ any person in any ananmran as in become subject m the Workers Compensation
Laws of Caldfpgroia.Dare
Applicant :J�1
NOTICE TO APPLICANT.IL after making this Ceniricam of Exemption.you should
become subject on the Worker's Campcasition provdsdoas of the LSM,Code,you must
.J z forthwith comply with such provisions or this Permit shall be deemed revoked.
Z ) CONSTRUCTION LENDING AGENCY
('+ '+ 1 bunchy afrirm that then u a eo arectim lending apia,Int the performance of
E
>
the weak far which Nis permit is isstxtl(Sac.3097,CN.Ca
a lender's Name
7 z Lenders Mace..
U 0 1 unify that I have rand this application and sate Rat the above information is
U, ^. correct.l agree to comply with all city and county ominmcn and mte laws relating to
0`r'J' building construction.and hereby mthoore¢preunutives of this city he enter upon Re _
aimve-mcntiomd property rorimpection purposes.
(~ 6. (We)agree se ave,indemnify and keep harmless the City of Caperton against
In liabilities.judgmeats,Cam and--proses which may in any way.against said City
U z ,n Ciescquenm of the granting of this permit.
'—' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: y Date ! " -0
SO CE REGULATIONS.
stg(aare of AppldcantCoo t — Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof i
Will the,applicant orfuurre building acupmtstore or handle hemdoce maba al
u dented by the Cupertino Municipal Cade.Chapter 9.11,and the Health and Safety
Code.Section sss3z(a77 #a
All roofs shall be inspected prior to any roofing material being installed.
Will Rc applinnl or future Wilding aavpant us equipment w dcWm which If a roof is installed without first obtaining an inspection,I agree to remove
emit hayardoas air contaminants as derired by the Bay Arta Air Quality Management 'all
Ddmdcrt new materials TOC inspection.
❑Yes VIN.
1 have rest the hicamims materials requdmnm us on@r chapter 6.95 of Re Califon.
oda HeaIR&Safety Cade,Such.25505.75533 and 15534.1 undersand that ifthc Wilding
dace not Cumntly have a¢naw.that it is my respeadislity m ondfy the amepmt of the
requirements orbic mum et prior to ismance of a Certificate of Occupancy. Signature of Applicant Date
054 1 0-7-01-66
Dwm,ormthorb dage., Dam All roof coverings to be Class')q"or better
CITY OF CUPERTINO
• 6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk': Lot: '
APN . . . . . . . . : 36911033 . 00
DATE ISSUED. . . . . . . : 07/01/2008
RECEIPT # . . . . . . . . . : BS000005315
REFERENCE ID # . . . : 08070010
SITE ADDRESS . . . . . : 10461 GLENVIEW AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOGHS GRINYASAN
ADDRESS . . . . . . . . . . : 10461 GLENVIEW AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4512
RECEIVED FROM . . . . : NORTH PACIFIC SERVI
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
• TELEPHONE
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 4, 400 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00
1MRRAA UNITS 1 . 00 61 . 19 0 . 00 61 . 19 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00
------ ---------- ---------- ----------
TOTAL PERMIT 224 . 85 0 . 00 224 . 85 . 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
I1
®kb"] o o 10
CITY OF CUPERTINO
Q` FURNACE/AC
O CUPEkTINO PERMIT APPLICATION FORM
APN# � � I I �33 . � � Date:
Building Address:
to
Owner's Name, Phone #:
Q2i �3a o6e�Z
Contractor: Phone#: 6-10 -3572 /80)
f���ll1 �A ci�iG S�RII �C E, Fax #:
Contractor License#: Cupertino Business License #:
Cep -5-
Contact:
Contact: Phone#:
S Ya ? 1 T-- 9'3?Z Fax #:
Building Permit Info:
Elect ❑ Plumb ❑ Mech
Residential Commercial
Job Description:
bD A 3�� res arc
For Residential Installations:
Attic ❑ I" floor ❑ 2"d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
L 4 ��
Strapped On Platform ❑ Bonded ❑ New Location Replacement ❑
Project Size: Express Standard ❑ Large ❑ Major ❑
Valuation:
L 00
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
a
Revised 6/16/08
CITY OF CUPERTINO
FURNACE/AC
ITY Or
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
IMCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl .
installation of controls regulated by this
code.
1MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by •
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed ¬ incl in an appliance
permit.
IBSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocate ea M •
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/ or M
replacement of ea appliance vent
install & not incl in an anni nermit.
} CITY OF CUPERTINO
FURNACE/AC
•CUPEiZTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst <=100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
IEPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1Bus LIC Business License B
•
CITY OF CUPERTINO
FURNACE/AC
ciTY OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= 10k CFM B
1MCRAA Commercial Mech Repair/alt/add M
IBSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
IBPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
IBREMAIRHAN Residential A/C units <= l0k CFM B
l MRRAA Residential Mech Repair/alt/add M
/ IBSEISMICR Seismic Residential B •
/ IEPERMITFEE Electric Permit E
�F 1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
/ 1TRAVDOC Travel Documentation B
113USLIC Business License B
•
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
R.
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15% Flyash Concrete, (note) S-1 5 points
M Structural 3. Uses Wood ]-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11.A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
•
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is •
not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
A.Site INPUT Resources Energy JAG/Health
1.Recycle Job Site Construction&Demolition Waste`
65%=1 point;75 = 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y--yes 0
4.Protect Native Soil 2 Resource pts y--yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stonnwater Practices 2 Resource pts y--yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pis y=yes D
1 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete •
25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 I
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood IJoists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6'or more 2 Energy pts y--yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Root 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y--yes 0
12.Use OSB
a.Subfioors 1 Resource pt y=yes 0 •
b.Sheathing 1 Resource pt y=yes 0
o
INPUT ReSOUTces Energy iAQ/Health
I.Windows
• 1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames 2 Energy pts y=yes D
2,Install Low Heat Transmission Glazing 1 Energy pt y=yes D
1 1 I
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes D
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Healers with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
. 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stovestinserts 1 IAQ/Health pt y=yes 0
b. InstalUReplace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 4 IAQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQMealth pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes - 0
• 1 1 1
Community Development
L%�J 10300 Torre Avenue
itCupertino CA 95014
'="
Telephone(408)777-3228
UPEkTINO Fax(408)777-3333
Building Department
JOB ADDRESS: PERMIT #
109W n6-0-? Ub7C7
OWNER'S NAME: Lc C v—)n}U A5j,,nJ, PHONE # Li o,? - ef
GENERAL CONTRACTOR: Pa,--r-rt AX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Own a or Signature Date