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14020157CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22772 ALCALDE RD CONTRACTOR: ROCHNS COMPANY PERMIT NO: 14020157 OWNER'S NAME: NEEL DHAMDHERE 2191 MONTICELLO AVE DATE ISSUED: 06/23/2015 1 O"ER'S PHONE: 4082213918 SAN JOSE, CA 95125 PHONE NO: (408)593-7405 DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL IBJ LICENSED CONTRACTOR'S 2 STORY ADDITION (1193 S.F.), ADD (N) License Class '2> Z O Lic. # S) BREEZEWAY(788S.F) & (1) ATTACHED GARAGE (410S.F), REMODEL IST FLR (1,930S.F.) _� Contractor Date I hereby affirm that I am licens d un de 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 Valuation: $250000 performance of the work for which this permit is issued. Sq. Ft Floor Area: I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 34244014.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DA IIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter INSPECTION. 180 DA upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Z3 costs, and expenses which may accrue against said City in consequence of the Date: t7 /5 granting of this permit. Additionally, the applicant u tands and will com e with all non-point so ce regulations per the Cu in unicipal Code 918. RE-ROOFS: Signature Date 6 —j _% S 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 Date: Signature of Applicant: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 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) HAZARDOUS MATERIALS DISCLOSURE property, rty, am exclusively contracting with licensed contractors to 1, as owner of the roe y g materials requirements under Chapter 6.95 of the construct the project (Sec.7044, Business & Professions Code). I have read the hazardous 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 Code, Section 25532(a) should I store or handle hazardous declarations: Health & Safety 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 defined by the Bay Area Air Quality Management District I Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as compliance with the Cupertino Municipal Co , apter 9.12 and performance of the work for which this permit is issued. will maintain the Health & Safety Code, Sections505, 2 a 5 4. I have and will maintain Worker's Compensation Insurance, as provided for by for this Date:6-Z� Section 3700 of the Labor Code, for the performance of the work which Owner or authorized ent: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, I must work's for which this permit is issued (Sec. 3097, Civ C.)Lender's forthwith comply with such provisions or this permit shall be deemed revoked. 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, which may accrue against said City in consequence of the I understand my plans shall be used as public records. costs, and expenses 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 918. Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: 14020157 22772 ALCALDE RD (342 44 047) ROCHNS COMPANY SAN JOSE, CA 95125 OWNER'S NAME: NEELDHAMDHERE DATE ISSUED: 06/23/2015 OWNER'S PHONE: 408-221-3918 PHONE NO: (408) 593-7405 LICENSED ONT TOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. # 18 7112 Contractor ROCHNS COMPANY Date 02/28/2017 _BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH _ RESIDENTIAL _ COMMERCLAL _ with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: 2 STORY ADDITION (1193 SZ), ADD (N) I hereby affirm under penalty of perjury one of the following two declarations: BREEZEWAY(788S.F) & (I) ATTACHED GARAGE (410S.F), 1. 1 have and will maintain a certificate of consent to self -insure for Worker's REMODEL IST FLR (1,930S.F.) Compensation, as provided for by Section 3700 of the Labor Code, for the: DEFERRED #2 - TRUSS CALC'S FrOR LOWER RO performance of the work for which this permit is issued. COUNTER IUOT ISS) G5-9,Lsp(&//{�� F �z" I have and will maintain Worker's Compensation Insurance, as provided for by DEFERRED #1 - TRUSS CALC'S. ISSUED 12/16/15 d ¢� o Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $250000.00 permit is issued. APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 34244 047 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, costs, and expenses which PERMIT EXPIRES IF WORK IS NC T STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, t2applicat understands and will comply with all non-pointsource regule Cupertino Muni ipal C ection 9.18. 180 DAYS FROM LAST CALLED SPECTION. a . re Date 6/16!2016 Issued by: ABBY AYENDE _Sign Date: 06/23/2015 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material be' installed. If a roof is 1.. I,. as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 6/16/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" C IR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOS RE 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 2553 , and 25534. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the a. 1 certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(x) should I store o r handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices air contaminants as defined by the Bay Area Air Quality A hich emit hazardous lanagement District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino unicipal Code, Chapter 9.12 exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sectio 5505, 3 and 34. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized ent: APPLICANT CERTIFICATION late: 6/16/2016 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGEN ' correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agent for the performance relating to building construction, and hereby authorize representatives of this city of work's for which -this permit is issued (Sec. 3097, Civ .) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 6/16/201'6 Professional CONSTRUCTION PERMIT APPLICATION o� COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION / 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255\0 +/ CUP RTINO (408) 777-3228 • FAX (408) 777-3333 • buildin-gPcupertino.org NEW CONSTRUCTION _ 9 ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS'2772 AI C A LD e a. ^ ' 6,sv« E WP NO CAI APN # 3q -z s ,I(, p - 01 - OWNERNAME WEEL, �"' DF_I� - PHONE40� 21x1"3 tig- EMAIL�, STREET ADDRESS P CITY, STATE, ZIP CA, Fqy 2�772� Air ���..;�►�� CONTACT NAME PHONE y �J ." "; E-MAIL1l®„DC+A)> I t h1 d c.�taci '`� atwi d STREET ADDRESS '.x2.3 SADT • CITY, STATE, ZIP N LCP.-AC44, 14 FAX _Va4tJv1t.L.0 t CA 9 4,06 —� ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOP R ❑ TENANT CONTRACTOR. NAME LICENSE NUMBER -LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME I$J.Df 4 AAA i -SA LICENSE NUMBER ` ii .BUS. LIC # —r COMPANY NAME t � � i ` � � � E-MAIL � , el. FAX STREET ADDRESS 2-S2., a #Yi�AeV_ J +' CITY�TAP 14tL.•^•LvG•�+••M`►:yL--4 . `I Lt SZ : PHONE DESCRIPTION OF WORK 6ftenAM4� " (lyet - -ri a),rM4VU 1L.P_ W _ EXISTING USE PROPOSED USE I CONSTR TYPE I # STORIES '-SI=12- 5n'F12_ VA `MLr% USE TYPE I OCC. I SQ.FT. I V LUATION ($) EXISTG AREA Z S3 4 NEW FLOOR AREA ).t q 3 DEMO AREA TOTAL NET AREA 3 527 BATHROOM REMODEL AREA +3® KITCHEN - REMODEL AREA OTHER REMODEL AREA 14 PORCH AREA DECK AREA - fj TOTAL DE K/PORCH AREA GARAGE AREA: J&DliTACH 5 GQ7 Op 410 NATTACH # DWELLING UMTS IS A SECOND UNIT SEC OND STORY S , ]YES BEING ADDED? NO ADDITION? NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN YES i2ECETOTAL VALU TION: PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER ROME?NO By my signature below, I certify to each of the following: I am the property owner o . norized agent to act roperty owner's behalf. I have rea this application and the information I have provided is correct. I have read the Description of Work and verify accurate. I agree to comply with all appli able local ordinances and state laws relating t uil m const ction. I authorize representatives of Cupertino to enter the above -identified property for inspection urposes. Signature of Applicant/Agent: _ Date: 9'2'7 1A 114 SUPPLEMENTAL INFORMATION REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgA,pp_2011.doc rev sed 06/21/11 RA CITY OF CUPERTINO BUILDING PERMIT'' BUILDING ADDRESS: 22772 ALCALDE RD CONTRACTOR: ROCHA'S COMPANY PERMIT O: 14020157 OWNER'S NAME: NEEL DHAMDHERE 2191 MONTICELLO AVE DATE IS UED: 06/23/2015 OWNER'S PHONE: 4082213918 SAN JOSE, CA 95125 PHONE ND: (408)593-7405 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: MM RESIDENTIAL CO ❑ RCIAL ❑ License Class f] Lie. # � "]� % 2 STORY ADDITION (1193 S.F.), ADD (N) BREEZEWAY(788S.F) & (1) ATTACHED GARAGE (410S,F); Contractor �` Date REMODEL 1ST FLR (1,930S.F,) I hereby affirm that I am license and he provisions of Chapter 9 DEFERRED #1" -TRUSS CALC'S.IISSUED 12/16/15 (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 Sq. Ft Floor Area: Valuation: $250000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 34244014.00 Occupan y Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NO STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT IS " DANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities; judgments, costs, and expenses which may accrue against said City in consequence of the Issued by: Date: i B 1 9 granting of this permit. Additionally, the applicant understands and will comply with all non -point sourgO regulations per the up in Municipal Code, Section 9.18. G RE -ROOFS: Signaty Date All roofs shall be. inspected prior to any roofing material beinE installed. If a roof is �� installed without first obtaining an inspection, I agree to remove inspection. all new materials for ❑ 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 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLO URE construct the project (See.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, a id 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(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 Quality anagement District I performance of the work for which this permit is issued. will maintain compliance with the Cu tino unicip%y a Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sections 2 05, 2 3 , a 5 Section 3700 of the Labor Code, for the performance of the work for which this r Owner or authorized at Dat 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 CONSTRUCTION LENDING AGE CY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (See. 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 ARCHITECT'S DECLARATIO indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said,City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date - - ---- CONSTRUCTION PERMIT APPLICATION COMMtUNI T Y DEVELOPMENT DEPARTMENT BUILDING pIVISlO 0 � 10300 TORRE AVENUE • CUPER T INO, CA 95014-3255 V Y (408) 777-3228 FAX (408) 777-3333 buildinO(dicuDertln0.or4 CUPERTINO ❑ 1\BW CONSTRUCTION ❑ ADDITION. ❑ ALTERATION ! TI _ ❑ REVISION / DEFERREDORIGMTAT. PF.RmTTy PROJECT ADDRESSI ,212 ApN j OWNERNAIYM I PHONE E:tfAIL � r STREET ADDRESS®� I CITY, ST ZIP � I FAX c+1 CONTACT NAI M PH E -IJ \ STREET ADDRESS- TTY, ST -, ZIP ( FAX e -A 144 zek ED owlma ❑. OR IvER-BLiII DER ❑ o A N ­.R AGEITr ❑ CO'17 ACTOR ❑ COI1TR,CTOR AGENT ❑ ARC=rCT ❑ ENGINEER ❑T EVELOPER. ❑ TENANT CONTRACTORN r I LICENSEN[JAf3ER I LICENSETYPE ( BUS. LIC COIJ,PAN-Y NAh�B E-1 LSIL FAX STREET ADDRESS CITY, STATE, ZIP I PHONE ARCi'STECTTr.NG,rEFRNAME LICENSE NUMBER f �y v�� BUS, LIC _ Cf ( J CObfPANY NAl✓" FAX STREETPDDPrSS I C STA PHONE a DESCRIPTION OF WORK EXISTRNG USE PROPOSED USE CONSTRTYPE 4STORIES USE ( TYPE I OCC, I SQ.FT. VALUATION (S) 'EM STG NEW FLOOR DEN/0 TOTAL AREA I AREA I AREA - I MET AREA I �- - BATHROOM olrMPR REMODEL AREA TmCHEN REMODEL 4REA REMODEL AREA PORCHAREA DECKAREA TOTAL DECKIPORCHAREA G.ARAGEAREA-, Ll DETACH ATTACH I DVIELLING UNTIS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? []NO PP.E-APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES Q - �D 3I — TOT VAL TION: - PLANNII4GAPPLm ❑N0 PLANI1AGAPPROVAL Lri1'ER I EICHLERHOME?. El NO _ By my signature below, I certify to each of the fo Nvina: I am the propel � '- 0% or authorize agent to act on the property owner's behalf. I have ead this application and the information I have provide s correct. I e read script n of work and verij it is accurate. I agree to comply with all applicable local ordinances and state laws relating to i onstrucfio , I th raze rese tives of Cupertino to enter the above -identified propel for in pection purposes. Signature of AD licant/A,a Date: A� V !/ SUPPLEMENTAL IN ORMATIO QUIREDTING clip .r r ❑ o��R i>�couNTEIz � suaDLN PLANI2EYTEii' ~ New SFD or'Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building — permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure i� cTAN7YYARD =❑ PUBi rc oRxs = _ Torn if any Hazardous Materials are being used as part of this project. QED ZtGJ _ Copy of Planning Approval Letter or Meeting with PIanning prior to - T — submittal of Building Permit application. ,IJLOR s 1 --SZT SERER-DI51".RICS - _—_ _— B1dgA-pp_,201l.Jdoc revised 06/21/11 CITY OF CUPERTINO FF.F. F.v%TTMATnlQ _ RTTTT.71TNf_ MVTCrnly ADDRESS: 22772 Alcalde Rd FEE DATE: 10/30/2015 REVIEWED BY: PAUL APN: 342 44 014 BP#: VALUATION: Suppl. PC Fee: Reg. 0 OT 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PME Plan Check: PRIMARY SFD or Duplex USE: PENTAMATION PERMIT TYPE: 1GENRE WORK Deferred #1 - Truss Calc's T0.01 hrs SCOPE PME Unit Fee: Alech. Plan Check Plumb. Plan Check �,7eci Plana Check .Meeh: Permit Fee: Plumb, Pcrnd I'ee: I;lec. Pearn I Fete: lher,,.Vech.Insp. 0iherPIvnibInsp. I I Othe,17Elea Insp. LJ I llech. Insp. Fee: Plumb. Insp. Fee: Elea Insp. I'ec NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District_ Ptl' )_ FEE ITEMS (Fee Resolution 1.1-053 Ef . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1� # Deferred Submittal . $286.00 IDEFSUBM . Suppl. PC Fee: Reg. 0 OT FO .0 1hrs $0.00 PME Plan Check: $0.00 Permit Fee; $0.00 Suppl. Insp. Feer Reg. Cl OT T0.01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construdion Tax: (lininistrative Fey. E) Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residen Building or ial Structure 0 A Thavel Documentation Tees. Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 — S $.00$286.00q $286.00 Reused: 10/01/2015 -, 2 7 zv /1 &4,e- Pv z4nv 2 2 772 ->� Al� e- � "a /X� -ek T//Z- S/,mss/S 7// ,00l�� .�� t (#/40Za = � IEX-lel� X�<6 z,6 -4(k 72- �KCj&O (6WAcl) ,s CUPERTIN0 ❑ NEW CONSMI)c CONSTRUCTION PERMIT APPLICATION = COMMUNITY DEVELOP44ENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 05014-3255 -- (408) 777-3228 FAX (408) r r7-3333 • buildino(cT,cuDErlino.org 1710N ❑ ADDMON . ❑ ALTERATION/TI RENMIO /DEFERRBD ORIGIN?.I.PERIJ-ii 4j PRO%Cf ADDRESS I APN 9 _ 1 w EXISTING USE PRO?OSED USEI CONSTR TYPE 4 STORIES 0V;I ER NA) -0. I ?'HON= = I✓AIL I USE TYPE OCC. STREET ADDRESS I Crri Y, Ai'c ZIP I FAX CONTACT NAME -;�Q' .ATMA AR..A E AREA 1�T AREA I STREET ADDR 5S CITYPYTE,Z P I FAX ❑ O'AW R Q OWN R -B=, M- ❑ OP,'XEz AG=iv r ❑ coN,'RACTOR ❑ comT kCTOR ',GTT ❑ ERCh1-CT ❑TGA*-'Ct ❑ DE\ =LOPS ❑ -1 /?, CONTRACI'ORNAI-rz I LICE2 SBNUIJ,EER I LICENSB 1YPB I BUS. LIC# ! COMPANY NA),r PORCH AREA DECK AR=A FAX I GARAGE AR =A:D=_TAC'i ❑AITAC3 STREET ADDRESS I CITY, STA i r-, ZIP PHOI�-z T DWMIINGU:A7r5: ARC•II-rrCt'rr-NGTJv:ER? AN.B ( LICE iNSE1�^B_R ( BL'S. LIC R COMPANYoe PRE -APPLICATION ICATION ❑17--S IF YES, PROVIDE COPY OF PLAN.1N1NGAPPL: ❑NO PLAN-Nni\,GA3PROVALL_ETTEREICHLERHOME? ISTFr BLDG A.>\` ❑ YES ❑>;0 TOT.kL. ON: By my signature below, I certify to each of the fello• .g: I am the property owner or nut zed agent to act on the pro e, oW ;,er's behalf. I have read this application and the information I have provided i r-,ect. I h rad the D iption ork and veriy it is accurate gree to -comply with all applicable loci ordinances and state laws relating to building st action, au rize re s , tat' i Cupertino to enter ffie zbove-identi-hed property for inspection pwposes. r SUPPLEI\fENTAL II\ ION REQ RE New SFD or Multifamily d%vellings: Apply for demolition p --=it for existing building s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bld,s: Provide a completed Hz_ardo S Materials Disc.o_t_re form if any Hazardous Materials are being used as put ofthis project. _ Copy of Planning Approval Let,er or Meeting with PlEn_Tiing prior to submittal of Building Permit application. "� � ���E sb..� STP.EET ADDRESS C,iY, ST n, ZIP �� MEIF LhG Li Rao {r � - ����oRTts —� ATS 5 IST�IC7 I Pi401 E DESC?2-11ONOFWORK Bldgl-pp_2011.doc revised 06/?1/11 EXISTING USE PRO?OSED USEI CONSTR TYPE 4 STORIES I USE TYPE OCC. SQ.rT. VALUATICN (i) EXISTG NEW FLOOR 5Eh40 TOTAL .ATMA AR..A E AREA 1�T AREA I BATI,ROOM KITCIL.- OTITZ R REMODEL AREA MIODEL AREA ?M14ODEL AREA - I PORCH AREA DECK AR=A TOTAL DECKAPOP.Ci A U -A I GARAGE AR =A:D=_TAC'i ❑AITAC3 - T DWMIINGU:A7r5: IS A SECOND UNrr ❑ YES BEING ADDED? E) NO SECOND STORY ❑1 c5 ADDITION? I,]NO I -- — PRE -APPLICATION ICATION ❑17--S IF YES, PROVIDE COPY OF PLAN.1N1NGAPPL: ❑NO PLAN-Nni\,GA3PROVALL_ETTEREICHLERHOME? ISTFr BLDG A.>\` ❑ YES ❑>;0 TOT.kL. ON: By my signature below, I certify to each of the fello• .g: I am the property owner or nut zed agent to act on the pro e, oW ;,er's behalf. I have read this application and the information I have provided i r-,ect. I h rad the D iption ork and veriy it is accurate gree to -comply with all applicable loci ordinances and state laws relating to building st action, au rize re s , tat' i Cupertino to enter ffie zbove-identi-hed property for inspection pwposes. Si�atereofApplicantl?.gent. Date: - SUPPLEI\fENTAL II\ ION REQ RE New SFD or Multifamily d%vellings: Apply for demolition p --=it for existing building s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bld,s: Provide a completed Hz_ardo S Materials Disc.o_t_re form if any Hazardous Materials are being used as put ofthis project. _ Copy of Planning Approval Let,er or Meeting with PlEn_Tiing prior to submittal of Building Permit application. "� � ���E sb..� �` m {{ .z�•��� �iiGcL>i COIIvTER g 1 � .� U +" -* E �� MEIF LhG Li Rao {r � - ����oRTts —� ATS 5 IST�IC7 Bldgl-pp_2011.doc revised 06/?1/11 CITY OF CUPERTINO IAI FF.F, ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 22772 ALCALDE RD DATE: 02/26/2014 REVIEWED BY: MELISSA PC FEE ID APN: 342 44 014 BP#: l *VALUATION: $250,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex 2nd Unit? Yes No OTC? 0 Yes (j) N0 PENTAMATION PERMIT TYPE: 1 R3SFDADD WORK 2 STORY ADDITION 1193 S.F. ADD N BREEZEWAY 788S.F & N ATTACHED GARAGE SCOPE (410S.F), REMODEL 1ST FLR (1,930S.F.) OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES 131" FEE ID R-3 (Hillside, Custom) II-B,III-B,IV,V-B 1,193 $4,824.02 IR3HPLNCK $1,986.54 IR3HINSP U (Private Gar/Ag Bldg) II-B,III-B,IV,V-B 410 $0.00 IUIPLNCK $1,252.00 IUIINSP Suppl. Insp. Fee -0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 1,603 $4,824.02 $3,238.54 MECH, HOURLY © Yes No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No MISC ITEMS l`1t U71?>, i': U7t Plan Check Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, Sanitary Newer District, Schooi nicl:int ain 1 Thaco foac oro hacod an tha nratiminary information available and are onlv an estimate. Contact the Dept for addn 7 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1;13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,824.02 1,930 s.f. $5,298.00 Remodel, Other IREMRES2 A Suppl. PC Fee: Q Reg. ® OT 0.0 hrs $0.00 PME Plan Check: $0.00 F 71 # $974.00 Covered Porch 1COVPORC7H Permit Fee: $3,238.54 Suppl. Insp. Fee -0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 '�'<IP1,Slt7 crion Zti:A: O Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: IPLLONGR $224.42 Select a Non -Residential Building or Structure Q i 'el l')c�t�rart�rrrturrrun ltIcs. Strong Motion Fee: 1BSEISMICR $25.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $10.00 SUBTOTALS: $8,321.98 $6,272.00 TOTAL FEF- $14,593.98 Revised: 01/15/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: PERMIT # BUSINESS NAME OWNER'S NAME: PHONE #K 1E Cabinets & Millwork GENERAL CONTRACTOR- BUSINESS LICENSE # a ADDRESS: CITY/ZIPCODE: ZzS *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 SUBCO CTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors:Zfl�� SignDate 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 Date CUPERTINO PURPOSE: CALGIREEN RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 101300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build i ng (aku perti no.org 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: Project Address: Project Description: Dhamdhere Residence 22772 Alcalde Road Addition/Remodel ILRE 10 Instructions: Y 1. The Owner or the Owner's agent shall employ a licensed professional experie� h the California Green Building Standards Codes to verify and assure that a I 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 Requirements Planning and Design - Site Development 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during QX El 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 I of 5 CalGreen_2014.doe revised 01/15/14 I .2 ENERGY EFFICIENCY General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. A4.3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 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.doc revised 01/15/14 Outdoor Water 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. .. .4 MATERIAL CONSERVATION AND RESOURCE EFFICIENCY Enhanced Durability and Reduced Maintenance 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected El 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 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. Building Maintenance and Operation 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. A4.5 ENVIRONMENTAL QUALITY Fireplaces 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 OX 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 El 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 OX 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. Interior Moisture Control 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 Air Quality and Exhaust 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the building are provided in every bathroom. Environmental 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 INSPECTOR 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 OX discipline they inspect and verify. Verifications 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 01/15/14 If Project Name: Project Address: Project Description: CALGREEN SIGNATURE DECLARATIONS Dhamdhere Residence 22772 Alcalde Road Addition/Remodel 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 2013 California Green Building Standards Code as adopted the City of up ino. . 02/06/2014 Owner's Signature Date Neel Dhamdhere Owner's Name (Please Print) 02/06/2014 Design Professional's Signature ) Date Inderjit Chadha / Design Professional's Name (Please Pnnt) 02/06/2014 Signature of License Professional responsible for CalGreen compliance Date Michael Chau - Build It Green 2008-011 650-799-7100 Name of License Professional responsible for CalGreen compliance (Please Print) Phone michael@msjconstruction.com Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen 2014.doc revised 01/15114 I BUILDING ENERGY ANALYSIS REPORT I PROJECT: Dhamdhere Residence 22772 Alcalde Avenue Cupertino, CA 95014 Project Designer: IBC Engineering 140 Cottonwood Lane Blackhawk, CA 94506 925-594-2302 Report Prepared by: C;y? 0 'Pa�O nent �3�a�ld�ncl , ULA jQI�+ LiAN�� Michael Chau, CEPE �oK U00E �oMP U PO Box 50722 Reglp'44 ay Palo Alto, CA 94301 650-799-7100 SUBMIT'-'W--- AO- Job Number: 2014900 OFFICE COPY Dade: 11/25/2014 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.com. EnergyPro 5.1 by EnergySoft User Number. 8156 RunCode: 2014-11-25T15:20:34 ID: 2014-900 I TABLE OF CONTENTS I Cover Page Table of Contents Form CF -1 R Certificate of Compliance Form MF -1 R Mandatory Measures Summary 2 3 9 EnergyPro 5.1 by EnergySoft Job Number. ID: 2014900 User Number: 8158 1 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF -1 R Project Name Dhamdhere Residence Building Type m Single Family ❑ Addition Alone ❑ Multi Family ® Existing+ Addition/Alteration 11112512014 Date Project Address 22772 Alcalde Avenue Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 3,527 Addition 1,193 # of Stories 2 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ❑ No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form. ❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Construction Type Area Special Cavity Features see Part 2 of 5 Status Wall Wood Framed R-13 1,058 Altered Roof Wood Framed Attic R-30 1,667 Altered Floor Wood Framed w/Crawl Space R-19 2,334 Altered Roof Wood Framed Rafter R-19 330 New Wall Wood Framed R-13 974 New Floor Wood Framed w/Crawl Space R-19 379 New Roof Wood Framed Attic R-30 1,061 New FENESTRATION U- Orientation Area(ft) Factor Exterior SHGC Overhang Sidefins Shades Status Front (N) 286.0 0.330 0.31 none none Bug Screen New Front (N) 48.0 0.770 0.40 none none Bug Screen New Left (E) 160.0 0.330 0.31 none none Bug Screen New Right (lM 96.0 0.330 0.31 none none Bug Screen New Rear (S) 48.0 0.330 0.31 none none Bug Screen New Skylight 32.0 0.390 0.29 none none None New Left (E) 98.0 0.710 0.73 none none Bug Screen New Right (lM 16.0 0.710 0.73 none none Bug Screen New Rear (S) 20.0 0.710 0.73 none none Bug Screen New Skylight 2.0 1.190 0.83 none none None New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Combined Hydronic see DHW No Cooling 13.0 SEER Setback New HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status Hydronic Radiant Floor Radiant Floor Ductless n/a n/a New WATER HEATING Qty. Type Gallons Min. Eff Distribution Status 1 Large Gas 0 0.84 All Pipes Ins New Ener Pro 5.1 by Ener Soft User Number: 8156 RunCode: 2014-11-25T15:20:34 ID: 2014-900 Pa e 3 of 11 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF -1 R Project Name Dhamdhere Residence Building Type ® Single Family ❑ Addition Alone 1 ❑ Multi Family ® Existing+ Addition/Alteration Date 11112512014 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 DHW System Noritz America Corp. N -0931M is a non-NAECA large storage gas water heater. Verify DHW details. The HVAC System Radiant Floor Distribution does not include a cooling system, field verification is not necessary. The HVAC System Hydronic Radiant Floor is a Combined Hydronic System that uses a Boiler for DHW and Space Heating. System details are on Part 5 of the CF -1R. 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., 6158 RunCode: 2014-11-25T15:20:34 ID: 2014-900 Page 4 of 11 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF -1 R Project Name Building Type ❑ Single Family ❑ Addition Alone Date Dhamdhere Residence ❑ Multi Family 10 Existing+ Addition/Alteration 11112512014 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2 r Space Heating 29.20 15.54 13.66 Space Cooling 13.65 8.47 5.18 Fans 7.00 2.77 4.23 Domestic Hot Water 11.20 7.51 3.69 Pumps 0.00 0.00 0.00 Totals 61.06 34.30 26.76 Percent Better Than Standard: 43.8 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) 776 334 Fuel Available at Site: Natural Gas (E) 671 258 Raised Floor Area: 2,713 (S) 615 68 Slab on Grade Area: 0 (M 742 112 Average Ceiling Height: 8.2 Roof 3,092 34 Fenestration Average U -Factor: 0.42 TOTAL: 806 Average SHGC: 0.39 Fenestration/CFA Ratio: 22.9% REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete_ Documentation Author Company 1112512014 Address PO Box 50722 Name Michael Chau, CEPE City/State/ZipCity/State/Zip Palo Alto, CA 94301 Phone 650-799-7100 Signed Date The individual with overall design responsibility hereby certifies that the proposed building 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 IBC Engineering 140 Cottonwood Lane Ind Chadha Address Name Y City/State/Zip Blackhawk, CA 94506 Phone 925-594-2302 Signed License # Date Ener Pro 5.1 by Ener Soft User Number: 8158 RunCode: 2014-11-25T15:20:34 ID: 2014-900 Pae 5 of 11 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project Name Dhamdhere Residence Building Type m Single Family ❑ Addition Alone ❑ Multi Family 10 Existing+ Addition/Alteration Date 1125/2014 OPAQUE SURFACE DETAILS Surface Type Area U- Insulation Joint Appendix FactorrCavitExterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Wall 230 0.102 0 90 Altered 4.3.1-A3 E=4.3.1 -A1 1st floor Wall 246 0.102 90 90 Altered 4.3.1-A3 E 4.3.1-A1 lstfloor Wall 386 0.102 270 90 Altered 4.3.1-A3 E=4.3.1 -A1 lstfloor Wall 194 0.102 180 90 Altered 4.3.1-A3 E=4.3.1 -A1 1sf floor Roof 1,667 0.031 R-30 0 0 Altered 4.2.1-A20(E=4.2.1-A2) 1st floor Floor 2,334 0.037 R-19 0 180 Altered 4.4.1-A4 E=4.4.1 -A1 1st floor Roof 2001 0.051 R-19 0 0 New 4.2.2-A 12 1st floor Roof 684 0.079 R-11 0 0 Removec 4.2.1-A2 1st floor Wall 56 0.102 R-13 0 90 New 4.3. i -A3 1st floor Wall 56 0.102 R-13 0 90 New 4.3.1-A3 lstfloor Floor 379 0.037 R-19 0 160 New 4.4.1-A4 lstfloor Roof 379 0,031 R-30 0 0 New 4.2.1-A20 1st floor Wall 100 0.102 R-13 0 90 New 4.3.1-A3 2nd Floor Wall 165 0.102 R-13 90 90 New 4.3.1-A3 2nd Floor Wall 1 2441 0.102 R-13 270 90 New 4.3.1-A3 2nd Floor Wall 1 3531 0.102 R-13 1 1801 90 1 New 4.3.1-A3 2nd Floor FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHGC Azm Status Glazing Type Location/Comments 1 Window 78.0 0.330 NFRC 0. 311 NFRC 0 New Milgard Classic Low -E Vinyl 1st floor 2 Window 48.0 0.770 NFRC 0.40 NFRC 0 New Milgard Dbl/Mtl Clr Low -E 1 st floor 3 Window 160.0 0.330 NFRC 0.31 NFRC 90 New Milgard Classic Low -E Vinyl 1st floor 4 Window 96.0 0.330 NFRC 0.31 NFRC 270 New Milgard Classic Low -E Vinyl 1st floor 5 Window 48.0 0.330 NFRC 0.31 NFRC 180 New Milgard Classic Low -E Vinyl lst floor 6 Skylight 32.0 0.390 NFRC 0.29 NFRC 0 New Velux Comfort+(74) Lowe2/Arg 1 st floor 7 Window 64.0 0.330 NFRC 0.31 NFRC 0 New Milgard Classic Low -E Vinyl 1st floor 8 Window 64.0 0.330 NFRC 0.31 NFRC 0 New Milgard Classic Low -E Vinyl 1st floor 9 Window 80.0 0.330 NFRC 0.31 NFRC 0 New Milgard Classic Low -E Vinyl 2nd Floor 10 Window 98.0 0.710 Default 0.73 Default 90 New Double Metal Clear 2nd Floor 11 Window 16.0 0.710 Default 0.73 Default 270 New Double Metal Clear 2nd Floor 12 Window 20.0 0.710 Default 0.73 Default 180 New Double Metal Clear 2nd Floor 13 Skylight 2.0 1.190 Default 0.83 Default 0 New Sin le Metal Clear 2nd Floor (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Window Exterior Shade Type SHGC H t Wd Ove hang Left Fin Right Fin Len H t LExt RExt Dist Len H t Dist Len H t 1 Bug Screen 0.76 2 Bug Screen 0.76 3 Bug Screen 0.76 4 Bug Screen 0.76 5 Bug Screen 0.76 6 None 1.00 7 Bug Screen 0.76 8 Bug Screen 0.76 9 Bug Screen 0.76 10 Bug Screen 0.76 11 IBug Screen 0.76 12 Bug Screen 0.76 13 None 1.00 Ener Pro 5.1 by Ener Soft User Number. 8156 RunCode: 2014-11-25T15:20:34 ID: 2014-900 Page 6 of 11 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1-R Project 'Dhamdhere Residence .- ri Single Family 0 Multi Family ■ Addition Alone 10 Existing+ Addition/Alteration OPAQUE Surface Type IM =0 MMUMM WIF-M ioi�ntAppenclix 4 Location/Comments FENESTRATION Exterior Shade Type - . • . . - . .' . .. MI.,• ••• -..- CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -1 R Project Name Dhamdhere Residence Building Type ❑ Single Family ❑ Addition Alone ❑ Multi Family © Existing+ Addition/Alteration Date 91125/209 BUILDING ZONE INFORMATION System Name Zone Name Floor Area ft New Existing Altered Removed Volume Year Built Hydronic Radiant Floor New Room 2,334 18,672 1956 Addition Room 379 3,032 New Room 814 7,326 Totals 1,193 0 2,3341 0 HVAC SYSTEMS System Name Qty. Heating Type Min. Elf. Cooling Type Min. Elf. Thermostat Type Status Hydronic Radiant Floor 1 Combined Hydronic see below No Cooling 13.0 SEER Setback New HVAC DISTRIBUTION System Name Heating Duct Ducts Cooling Duct Location R -Value Tested? Status Hydronic Radiant Floor Radiant Floor Ductless n/a n/a ❑ New El El WATER HEATING SYSTEMS S stem Name Qty. Type Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE Standby Loss or Pilot Ext. Tank Insul. R- Value Status Noritz America Corp. N-09 1 Large as All Pipes Ins 250,000 0 0.84 0.00% n/a New MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length ft 0 0 i� a Q —I System Name Pipe Length Pipe Diameter Insul. Thick. Qty. HP Plenum Outside Buried ❑ Noritz America Corp. N -0931i 0 0.50 0.50 Ener Pro 5.1 by Ener Soft User Number: 8158 Run Code: 2014-11-25715:20:34 ID: 2014-900 Pae 8 of 11 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R Project Name Dhamdhere Residence Date 11112512014 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)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of 10-111 (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. §118(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 Ll -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 Ll -factor. 150(f): Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95 2000 when specified on the CF -1 R Form. 1 50 : 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 2.0perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)l 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 -fitting damper 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 ACOA. §150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1506)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. §1500)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. §1500)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. §1500)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, including that due to sunlight, moisture, equipment maintenance, and wind. §1500)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. §1500)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 by EnergySoft User Number: 8158 RunCode: 2014-11-25T15:20:34 ID: 2014-900 Page 9 of 11 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R Project Name Date Dhamdhere Residence 11112512014 §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 efficacy 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. EnergyPro 5.1 by EnergySoff User Number: 8158 RunCode: 2014-11-25T15:20:34 ID: 2014-900 Page 10 cf 11 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R Project Name Date Dhamdhere Residence 11112512014 §150(k)10: 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)l 1: 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)l2: 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)l3: 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)15: 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)l6: 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. EnergyPro 5.1 by EnergySoft User Number: 8158 Run Code: 2014-11-25T15:20:34 ID: 2014-900 Page 11 of 11