08050042 CITY OF CUPERTINO r '+"a'''di�TRwsvra dam '=
BUILDING DIViS1ON PERMIT CONTRAC�TOR�INk'C1RMA.TION
BwL91UNITE FIR CT GENMOR PLUMBING PER
MIT NO.
'G08050042
OWNER'S NAME: PERMIT ISSUE DAIS
STEVE SCHLEIMER 2552 SEABOARD AVE 05/02/2008
NE: SANITARY NO, CONTROL NO.
ARCHITER/ENGINEER: COOPER RE—PIPE & WATER BLDG BELEECT PERMIT UIOMBMECH
O O O O
goo LICENSED CONTRACTOR'S DECLARATIONHEATER
70b Description
F 1 hereby affirm and sm liciued under pomiumu of Chapter 9(Commencing
^x`uj with Section Transit)of Division 3 of NC BusiM.•and Pr.fessiou Cade,add my license
< in full forte and eH
License Clw l,ic.g
t:o e Mn ecser
DEDakCT
I undersand my phra shall he mud as public records
Dau
g C t; Licensed Professional
s v,5OWNER-BUIIEER DECLARATION
f 1 hereby ef".that I am exempt from the Conumloes License Law for the
COO following mason.(Section 7031.5.Business and Pmfahiom Cede:My city or county
which acquires a permit On cmatruct.alar.Improve,demolish,or repair any dmcture
prim in its issuance.alto mquims the applicant fmiuce permit in rile a signed sudement
x< thuhcislicensedpurwanuotheprovisiomofineComment'slJttvcLaw(Chapter9 Sq.Ft. Floor Area Valuation
yFg (commencing with Section 7008)of Division 3 of the Buslneh caw R rwisiou Code)or
`< Nat I e is exempt therefrom and the hue for the alleged exempt...Any Holatino of
Section 7031.5 by any applicant Turn pemit subjects Nc applicant to a civil Penalty of APN Number Occupancy
nmm.m Nam five hundred dollars(SM P Y Type
❑I.uowner of Ne properry.cmY wployees with wvgesu thea sole compewUen,
will do the worLond the swctum is Out intended in offered for sale,(See.70th.Business
and Pmfesed.Cod.The Conlmmrs License Law does not apply in an owner of Required Inspections
property who builds orimproves t eren.,aw whodocssuch workhimselfcar through be
awn employees,provided that such improsemsnh art not intended.roffered formic.If.
however.the buiidingm improvement hsold within onc yea of eemplet.n.Ne ownm-
builder will have Ute Widen of proving that he did not build or improv for purpose of
sale.).
0 I,as owner of the properly,am exclusively contracting with licensed c.ntm.mrs he
comnct tie project(Sea 7044,Business and Professions Code:)The Conrrecmra Li. .
cane law doe not apply to an ownm of property who builds or improves Demon.and
who contracts for such Projects with a conustor(s)licensed pursuant in the Contractor's
License Law.
O l sm cumpl under See ,B&P C for this reasan
Owner Date
WORKERS COMPENSATION DECLARA330N
1 hereby affirm under penalty of perjury one of the following declanUons:
I Its.and wfl maintains CerdifiuN of Consent in self-iesure fm Work es Compcn-
niton,as provided for by Seeman 37M of the Labor Cade-for Ute perfarmanm of the
work for which this Permit is issued.
0 1 have and will maintain Warkers Compeosaion losuana,as mi i ired by Section
3700.1'the labor Code,fm Ne Perfomama of die work furwhich Nis Permit a Issued.
My Workers Com acenaton Insem.ec aria and Policy number art: l
Cubs'G A .R(,Lr3yC�Policy No �� O 0 C/
CERTIiFICATE P EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(The section need m i be completed if tic permit is(mom hundred dollars($100)
or kas)
1 cenifY that in Ne pufmmancc of the work fm which this permit a issued.l shall and
employ any person in any exmnerm as to become subject N the Workers'Compewton
Laws of Califomia.Dam
Applicml
NOTICE TO APPLICANT:IL after making this Cmtirate of Exemption,you should
become..him no Nc Workers Compensation provisions of Ne Iabm Code,you mud
.J O forthwith comply with such provisima or Ne permit shall be doomed nodded.
Zn CONSTRUCTION LENDING AGENCY
[-r I hereby&Mat Nat Vert is a condmetin t lending agency for Nes performance of
!Y the work for which the Permit is issued(Sec.3097.Civ.C.)
A Lenders Name
z lenders Address
U O 1 unify that 1 have lead Itis appliemint and sure the the above information is
tla F carred I agree N comply with all city and county onlinaeco and suite ewe achting to
0U building consumdon,and hereby mNmim reemsentuivc of Ne city in enmrupon 0e
W show-mentioned property for impmuon puywee.
G es ju agree m mw,indemnify Nd limp hay in m w City of Cu imina id City
fay incoites.jwgme.h creed ofin OfLhiaeswhich may in any way accrue against said City
Uz AcPLICANT of NeRM.N of thhDWVl.
'--' APPLICANT UNDERSTANDS AND WI LY WITH ALL NON-POINT Issued by: Date
SOURCP�REGULATIONS. /
ci—aa� r'O
Signature ofAppHcuwiComWmr ate
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will de applicant Of future building atupantsmre or handle hararmus mamriat
as defined by the CUPertin.Municipal Code.Chapmr 9.12,and the Health and Safety
ewe.Section
on 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
res
If a roof is installed without first obtainingan inspection,I agree to remove
it Wie the applicant car f art building o¢upam use eyvipment.r devices which Pe g
kmhvalloos air canurrri a u der. the Bay Asea Air Quality Management all new materials for inspection.
GYes Nu
I have read that hamdous materials requiremmh under Chapte,d.95 oflhe W ifor.
me Health&SafclyCode.Smfimd 5503.25533 and25534.I undersand Natifthc building
does note n haw v tevnt.Nu It a my responsibility m nwfy tic occupant of Ne
roe' chmuu ' rmissu a .e or
a Signature of Applicant Date
Owner of a.N.m>ed age., Dam All roof coverings to be Class.4.or better
CITY OF CUPERTINO .
• 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35905083 . 00
DATE ISSUED. . . . . . . : 05/02/2008
RECEIPT # . . . . . . . . . : BS000004656
REFERENCE ID # . . . : 08050042
SITE ADDRESS . . . . . : 21110 WHITE FIR CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : STEVE SCHLEIMER
ADDRESS . . . . . . . . . . : 21110 WHITE FIR CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4234
RECEIVED FROM . . . . : GENMOR PLUMBING
CONTRACTOR . . . . . . . : GENARO MORALS LIC # 27101
COMPANY . . . . . . . . . . : GENMOR PLUMBING
ADDRESS . . . . . . . . . . : 2552 SEABOARD AVE
CITY/STATE/ZIP . . . : SAD? JOSE, CA 95131
TELEPHONE . . . . . . . . : (408) 855-8348
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BPWATER UNIT 1. 00 40 .79 0. 00 40 .79 0. 00
1BSEISMICR VALUATION 4, 900. 00 0. 50 0 . 00 0. 50 0. 00
IPPERMITFE FLAT RATE 1 . 00 40.79 0. 00 40.79 0. 00
1PRWHEATR UNITS 1 . 00 24 .48 0. 00 24 .48 0. 00
1TRAVDOC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 147 . 35 0. 00 147 . 35 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 147 . 35 6435
---------------
TOTAL RECEIPT 147 . 35
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
301 ROUGH PLUMBING 507 FINAL PLUMBING
•
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
• CUPEkTINO PERMIT APPLICATION FORM
0 SOS 0
APN # Date: O 8
35
oS �3.ov
Building Address:
C9/ U - C 14 �- / i�—
Owner's Name: Phone#:
'909 -366
Contractor: Phone95,57-03' Y8
#�: p (� ? (� []
r T06-9A)
O 95,S 0 J G 8
Gf'ac� L 11 /A) Fax #: 0 7 — 6
Contact: Phone#:
36 — 9 33y6 / Fax #:
Contractor License#:
Cupertino Business License#:
Job Description: /
C o O P /Z - <?10/c E C!�/��C'� - G1 7 <=k
Residential Q/ Commercial Q
Valuation:
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.
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCSEWER Commercial building P 11CPSS
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1 PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial P
1BSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
labs,- REPIPE/SEWER/MAIN SERVICE
CUPEkT`INO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
IBPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
` IBPWATER Install/alter Water Pipe P
r 1BPFIXTURE Plumbing Fixture P
IPGASRES Residential Gas Piping System P
1-4 Outlets
I BPGAS Gas Piping System 5+ Outlets P
/ I PPERMITFEE Plumbing Permit Fee Issuance P
1PLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
ITRAVDOC Travel & Documentation Fee B
1BUSLIC Business License B
�� w14 e cct-1Z
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
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
D. Structural 3. Uses Wood I-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 oints
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
•
a
�D
coo/
n
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.
INPUT Resources Energy IAQIHealth
A.Site
1.Recycle Job Site Construction&Demolition Waste I
65%=1 point;75%= 2 points;BO%=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
B.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 pts y=yes 0
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 p
1 1
C.Structural Frame 1
1.Substitute Solid Saws 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 I-Joists 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
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPs)
a.Floors 3 Ener is
9Y P Y=Yes 0
b.Wall
3 Energy pts y=yes 0
c.Roof 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.Subfloors 1 Resource pt y=yes 0
• b.Sheathing _ ' 1 Resource pt y=yes O
1 t 1 r
INPUT ReSDurces Energy IAO/Health
xtenor Frmsh
11.Use Sustainable Decking Materials
a.Recycled content 3.Resource pts y=yes 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 1 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
1 1 1
E.Plumbing
1.Install Water Heater Jacket __ _ 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts Y--yes 0
"Retrofit all Faucets and Showerheads w th Flow Reducers
a.Faucets(i point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) I Up to 2 Resource pts. 0
4.Replace Toilest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filler on Showerhead 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0
8,Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r-.tiecmcin
1.Install Compact Fluorescent Light Bulbs(CFLs) 1
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) j Up to 4 Energy pts. 0
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to •
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy of y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.
all Built-In Recycling Center 3 Resource pts y=yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y--yes 0
3.Insfall Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 3 IAQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes 0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
D.callings 4 Resource pts . y=yes 0
I.Windows INPUT Resources Energy A011-learth
11.Install Energy-Eifcient Windows
• a.Double-Paned
1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
I c.Low.Conductivity Frames I
V__ Y J 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt Y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
`1.Use Duct Mastic on All Duct Joints
—1 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 pl y=yes 0
4.Clean all Ducts.Before Occupancy 2 IAO/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 31AO/Health pts y=yes 0
b.Water Heaters 31AQ/Health pts y=yes 0
9,Replace Wall-Mounted Electric and Gas Healers with
Through-the-Walt 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 stoveslnserts 1 IAQ/Health pt y=yes p
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 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health 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 p
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
r g _ 1 Resource t
(6.Select Safe and Durable Roofin Materials_ p y=yes D
7.1lnstall Radiant Rar er J 3 Energy pts y=yes 0
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
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
•
_iVi
ndoor Air Quality and Finishes INPUT Resources Energy JAWHealth
1.Use Low/No-VOC Paint _ _ _ 1 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes _ 2 IAOMealth pts y=yes 0 •
31 Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF41AQ/Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
L"Use Rapidly Renewable Flooring Materials_ 4 Resource pts y=yes 0
3.Use Recycled Conteinf Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 51AQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y--yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total Points Aval able: 1401 1301 57
Total Points Project Received: <6-1 0 0 0 •
G:data/progslgreenbuildngguidelineslremodelerslgreenpointsfinal2.12.e4proteded.xis
I •
r
Community Development
10300 Torre Avenue
kJ Cupertino CA 95014
Telephone(408) 777-3228
CITY OF
UPEI�TINO Fax(408) 777-3333
�
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: Sf e .z (Q; PHONE # off
GENERAL CONTRACTOR• NHo FAX # OB'2217-61191
I am not using any subcontractors: 5-6a -o g
Signature Date
Please check applicable subcontractors and complete the followin information:
60 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
Owner/Contractor Signature Date