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B-2016-1996CITY OF CUPERTINO BUILDING PERMIT BUII DINGAI2DRES5: CONTRACTOR: PERMIT NO: B•2616-1996 HOMESTEAD TEAD RD CUPERTINO, CA 95014-0499 (326 10 066) BUILDRITE Ar�} �(� o CONSTRUCTION CORP KENNESAW, GA 30144 R'S NAME: SOBRATO INTERESTS i ETAL 'DATE ISSUED: 09/27/2016 1OWNER°S PHONE: 408-45.3-7430 PHONE NO: (770) 971-47$7 Lic nse Class j} Lic. #97-6028 Cor actor BUILDRITECONSMLICTION CORP Date 12/3112016, eby affirm that I am licensed under the provisions of Chapter,9. (commenemg Section 7000) of Division 3 of the Business & Professions Code and that my se is in full foree and effect. eby affirm under penalty of perjury one of the following two declarations: 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. >z '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 permit is issued: APPLICANT C>i RTIFI ATION ify that I have read this application and state that the above nation is correct. i agree to comply with all city and county ordinances state laws relating to building construction, and hereby authorize sentatives of this city to enter upon the above mentioned property for sction purposes. (We) agree to save indemnify and keep harmless the )f Cupertino against liabilities, judgments, costs, and expenses which accrue against said City in consequence of the granting of this permit.. tonally,, the applicant understands and will comply with all non -point ;e regulatt gA er the Cupertino Municipal Code, Section 9.18. Date 09/27/2016 reby affirm that I am exempt from the Contractor's License Law for one of the Wing two reasons: 1. I, as owner of the property, or my employees with wages as their sole compensation, will do the work,. and the stnicture is not intended or offered for sale (Sec.7044, Business & Professions Code) z. 1, as owner of the property, am exclusively contracting with licensed contractors:. to construct the project (See.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: [I. 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3704 of the Labor Code, for the perfoimance of the work for which this permit is issued. 3. I certify that in the performance of the work for Which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. if, aftermalang this certificate of exemption, Ibecome subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. i APPLICANT CERTIFICATIOliT certify that I have read this application and state that the above information is Cortat I agree to comply with all city and county ordinances and state laws rela ing to building construction, and hereby authorize representatives of this city toe. er upon the above mentioned property for inspection purposes. (We) agree to s ve indemnify and keep harmless the City of Cupertino against liabilities, judments, costs; and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code; Section BUILDING PERMIT INFO: BLDG —ELECT -PLUMB MECH _ RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: T.L -1459 SQ FT - H&R BLOCK /0 -:a - Sq. Ft Floor Area: l Valuation: $100000.00 APN Number: Occupancy Type: 32610 066 B (Tenant Improvements) PERMIT EXPIRES -IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERAUT ISSUANCE OR 180 DAYS FROM LST-C.A&L-Eft ECTION. by: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree toremove all new materials for inspection. Signature ofAppiicant: Date: 09/27/2016 "All HAZARDOUS' MATERIALS. DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material ' Additionally, should i use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code; Chapter 9.12 and the Heaith�& Safety Cod ns 25505, 25533, and 25534. Owner or authorized a ant. Date: 09/27/2016 I hereby affirm that there Is a construction lending agency for the performance of`worles for which this permit is issued- (Sec. 3097, Civ C. ) Lender's Name _ Lender's Address ARCHITECT'S DECLARATION understand my plans shall be used as pub Ni records. Licensed - Sign, ° .-_� _ - - Date 09/27/2016 Professtoi CONSTRUCTION PERMIT APPLICATION EM r COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO,CA-95014-3255 (498) 777.3228 • FAX 1408) 7773333 • building@cupertino-ora . 0 N6W CONSTRUL n0N D ADDITION A ALTERATION / TI ® REVISION! DEFERRED ORICTINAL PERMIT ii YROICCTAt)llRli ��p AD � AIN# _ 1t6M S �� il "„ 10µ' STREETADDRE9S =- ry ID 9'h .. .. . C[TY, STATS ZIP f� 6A FAX - CONTACT NAME N$ -2-7r-" 777 t cixt�l7tiG:" . CO S7RRETADDR9S8' pd v -33M4 CITY,STATE, l70lvl GA 'PAXa 13 OWNIM 13 DwNERHUAvaa. M owNHd AOBNT ❑ CONTRACTOR r- CONrRAGToit AGENT I ARcurracr EI ENarreEER ID. nmviJLOPErt ( TENANT CONTICACTORNAMB'..i LICENSE----.- 1dCEN5ETYPS. . BUS..LiC# (./'.. p. /} COMPANYNAML> - /j♦ • _�'� fs' R-V�AIL . - • �:�._�, a d ii(J FAX STRP,RT ADORSSS C1 a ARC1IITliCTIk SO1NBHRNAT3L .. LMENSENUMBEa ..+ l-77 ... ... - EUS•LIC# - - COMPANYNAMd _. -. fj� .. B-Mhu. - FAX _ 231, SCRIifiTADIHtESS j/- : '" .. Cr'�� TA TR 1, dV -.. MD PIiONt;12 .e Zit 1.57P6 ' DEsmu"1011 OF WORK jj� _ [C� -_ TQpJrfUSL' /g�ttJF�0g8¢O U56 - Uv$iA2SS. .1,1] pV}�iL.•GC�S CONS TYPE ~ aSTORMS- USI& TYPE OCC. SQ.Fr. VAWATIONtSI. - JO NEW Omit- DEMO .AREA - AREA AREA TOTAL NET AREA J� iC. W" /0 �s°i+.. g hf� •6i' . V dd 1✓ Rif/ I sATHRooM xlrcusnt otsJeR REMOOM.Al(GARJ }ci REMODEL ARRA /(/ � - R¢MOOHLARB& —MIA t/(t _ 111 P6¢A J7LGKi ' ' 7Oi'AL Q ORCH ARRh (i ATTACH MDNJ'LLINGUNrfS7 FSASECONDUNCT Elym 1HUNGADDEm sECONDSTORY E]YES ADD1T[ON9 ONO A QNO PRE-APPLrATiON MyEs ntYrim ROvJDECUPYOP ISTHBHLUGAN .[3Yns G...._ D.$1`" "'� TO LVALUATION. i7-ANNIN6 APP.LR 1]NO PIr1NNDI�APPROYALLETTER - RICHLERnOMLB [IND ?a - By may signature; bolow, I certify to each of the following: Iain the property owner or authorized Spat 0 act on lh . property owner's behalf. I have rcad this application and the information I have provided is correct. I have read the Description of Work and verify it is grcurate. I agree to compiy with all applicable local ordinances and state laws relating to'Idinsconstrp Imtthotizerepresentatives ofCupertinotoenter the abo-idmflfiedprop/ertyfor impoctionptrrposes. \ "bdSigoattaeofApplicallU ZL%1 i; - Date: 9UPKBMMqM INFORMATION REQ RED - = ' �€I g y�� g � -, � gc2rl�?I<itts>trJy-�=-•- _ :�- Mme_ -��DODiDIIt`Si:PtESSt=s; New SFD or Multifamily dwellings; Apply for demolition: pen -alt. for existing building(s). Demolition permit is required prior to issuance o€building- pmnit for new building. Cotnmoreial Bldgs: Provide a.completed Hazardous Materials Disclosure rf si3ntn' z a=te x PulSza'C d>=='w _ form ifany Hazardous Materials -tire Ueingused as part ofthis project, ='�:.',.». W_.._._� _,; .. -,.... -�:-•_ __.W_ _• - _ Copy of Planting Approval Lector or Meeting with Plannigg priarto - _ _ _= _ =- == ` `- submittal ofB iiding Permita lication. Budding, . Fp Bk[9APP 201LdocJ•evftd0021111 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: j` �o J & PERMIT # 7 OWNER'S NAME: PHONE # j GENERAL CONTRACTOR: `— -9,P Tal BUSINESS LICENSE # ADDRESS: l > CITY/ZIPCODE: `�- -vur municipal code requires all businesses working in the city to have a City of Cupertino busi'negs license. NO BUILDING FINAL .OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors = --� "S�inature Date Please check applicable subcontr�s 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 d Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date CALGREEN NON-RESIDENTIAL CHECKLIST — MANDATORY ITEMS I M I I COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION cupriRTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 950114-3255 (408) 777-3228 • FAX (408) 777-3333 • building(Dcuoertino.org PURPOSE: The non-residential provisions of the 2013 CalGreen Code outline planning, design and development methods that include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines means of reducing the quantity of air contaminants. Project Name: + R 131 0A L p Project Address: 4_0 ) �D k oa d Project Description: 2n&ntIQ�Q Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3, Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector, Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements CHAPTERNONRESIDENTIAL MANDATORY MEASURES The project meets all the requirements of Divisions 5.101 through 5,508. ❑ Division PLANNING I DESIGN '4--3 ` 1?1an Sife'Develo merit �� t �5, k��, InJanUJbesign , {<x�ts 'uz t4L.F r 3.H `a ..7 , "'h.ry '4 U aY. „'u�-Ir4".i t,��L'� s,.�+, ��'. ...:�.._t51•� .-i `X-4 t'S _._, ii Yv`� � 5.�. } -.ts l.:�._?z 5.106.1 Storm wafter pollution prevention. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been P lA designed, specific to its site, conforming to the State Storm water NPDES Construction Permit or local ordinance, whichever is stricter, as is required for ❑ projects over one acre. The plan should cover prevention of soil loss by storm water run-off and/or wind erosion, of sedimentation and/or of dust/particulate matter air pollution. Page 1 of 9 C U P E RT I N( ,'Green Non -Res CheckhAdoc revised 01/23114 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld Hom Date: 09/13/16 5.106.4 Bicycle parking. Comply with Sections 5.106.4,1 and 5,106.4.2; or ❑ ❑ meet local ordinance, whichever is stricter. 5.106.4.1.1 Short-Term bicycle parking. If the qualified project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers-by, ❑ ❑ for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two-bike capacity rack. 5.106.4.1.2 Long-Term bicycle parking. For qualified buildings with over �_ ► l��y Iv lC ❑ 10 tenant-occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low-emitting, fuel-efficient and carpool/van pool vehicles as --0 - N/A ❑ shown in Table 5,106.5.2. 5.106.8 Light pollution reduction. Outdoor lighting systems shall be _❑N/A ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones N/A ❑ 1 -- 4 as defined in Chapter 10 of the California Administrative Code; and 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM-15-11; and -'❑-'__ N/A ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 Grading and paving. The site shall be planned and developed to 1 fn Construction indicate how ❑ keep surface water away from buildings. plans shall Il f t site grading or a drainage system will manage all surface water flows. Division —`.l1'F ';F :-'`j;`..t -. i�J% j is .r4rr'`s"v �` .sv;'•: };Y� :,it=:. Rf��i �t }-�i F ":� . 5�fn- - 'm.1.19-11-.-� . p i` 2`S:INK ','�`..5.: •.Ll[r - ai'Y•'t'7Ls's{�^iry '�W F '.i�J- „ r� S� YFr' 5.201.1 Scope, The California Energy Commission will continue to adopt � ❑ mandatory building standards. Division i AND CONSER Pndgor,1(a#e f' z `1 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1.1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. N/A ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the _�N/A ❑ building projected to consume more than 100 gal/day. 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater N/A ❑ than 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot-water boilers with energy input > 500,000 Btu/h. Page 2 of 9131 C U P E RT I N O CalGreen Non -Res Checkltst.doc revised 01/23/14 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld Hom Date: 09/13/16 5.303.1.2 Excess consumption. A separate submeter shall be provided for any tenant within a new building or within an addition that is projected N/A ❑ to consume > 1,000 gal/day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate values shown in Table 5.303,2,3, ❑ Exception: Building that demonstrate 20 -percent overall water use reduction, 5.303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall ❑ apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water -conserving fixtures or ❑ 2. Utilizing non -potable water systems, -94)/-A ❑ 5.303.6 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code y-_11_1 ❑ (CPC), and shall meet the applicable standards referenced in CPC Table .�; 1401,1 and CalGreen Chapter 6, y �5M"a; 5.304.1 Water budget. A water budget shall be developed for landscape t� �LI ❑ irrigation use, 5.304,2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least p p_ / �T ❑ 1,000 sq,ft. but not more than 5,000 sq.ft., separate submeters or metering devices shall be installed for outdoor potable water use. 5.304.3 irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft. of cumulative landscaped area, install irrigation controllers and sensors which �� El the following criteria, and meet manufacturer's recommendations, 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as WN ❑ weather conditions change. 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 communicates NSA —EWA ❑ with the controller(s), Soil moisture -based controllers are not required to have rain sensor input. z 5.407.1 Weather protection. Provide a weather -resistant exterior wall and foundation envelope as required by California Building Code Section 1403.2 .� �� ❑ and California Energy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent.' Page 3 of 9 C U P E RT I N 0 c&Greert Nott Res Checklist.doc revised 01123114 131 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16 5.407.2 Moisture control. Employ moisture control measures by the following methods; d —e—�1' ❑ 5.407,2.1 Sprinklers. Prevent irrigation spray on structures. 5.407.2.2 Entries and openings. Design exterior entries and/or openings N� ❑ to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and--8-�� ❑ wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following: 1. An installed awning at least 4 ft in depth. 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection. 5.407.2.2.2 Plashing, Install flashings integrated with a drainage �► V1� ❑ plane. ,gvlg 1#Ss am ,�� 5.408.1 Construction waste management. Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408.1.1, 5.408.1.2, or 5.408.1.3; or meet a ❑ local construction and demolition waste management ordinance, whichever is more stringent. 5.408.1.1 Construction waste management plan. Submit plan per this ❑ section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408, 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square ❑ foot of building area may be deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5,408.1.4 Documentation. Provide documentation of the waste ❑ management plan that meets the requirements listed in Section 5.408.1.1 through 5.408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land —❑—�� ❑ clearing shall be reused or recycled. 44,5,� _ 1.� - - __ :tA, t`"".t.-v �L tiz..:. _ �S"_,E YA *�-4 �y utt A. 1 1 � � � �L 7 �t 4`y. at�ti`�.r. t F � yM1t 3F.� 3 L }E } f3� �1•iG 3�'�"`.��R�L �54 "uilitlg IVI�,I}�;fe�dgCe �dt,V�G�jctk��i�dd � t # � v i1 y � 4 4 _ - Lam:='t:IC;>.r. _._{{y_ r µ':s.4:.t.:,c:v.,':Y`:ic@e.ti4iti LTh� � � '.� �k1n � f �l ami t 7�5 `�c� —t'�yh�6f , 5.410.1 Recycling by occupants. Provide readily accessible areas that serve the entire building and are identified for the depositing, storage and collection ❑ of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the Q' -BImo/ A ❑ design and construction processes of the building project. Commissioning requirements shall include items listed in Section 5.410.2. Page 4 of 9131 C U P E RT I N O CalGreen Non -Res Checklist. doe revised 01123114 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16 5.410.2.1 Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in f� ❑ Section 5.410,4, 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems - -[�- hid ❑ listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of P )A.. PJA- ❑ the building project and shall include items listed in Section 5.410.2.3. Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each `-❑ �/% ❑ component, system and system -to -system interface in accordance with the ❑ approved plans and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems�� ❑ operations training are required. 5.410.2.5.1 Systems manual. The systems manual shall be delivered to ❑ the building owner or representative and facilities operator and shall �' (�1 Include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type and/or systemNI ❑ shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and "�IV/ ❑ reporting recommendations for post -construction phases of the building project shall be completed and provided to the owner or representative, 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303,1, 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall ❑ Include, as applicable to the project, the systems listed in Section 5.410.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures In accordance with industry best practices and applicable national standards ❑ on each system. 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a building or space is operated for normal use, the system should be balanced In accordance with the procedures defined by ❑ national standards listed in Section 5,410,3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for n performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of ❑ guaranties/warranties for each system prior to final inspection, 5.410.4.5.1 Inspections and reports. Include a copy of all inspection El and reports required by the enforcing agency. Page 5 of 9 FMIJ] C U P E RT I N OCalGreen Noir Res Checklist, doe revised 01/23114 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16 st.. { k. Vit' '1.� { ty ,Its t i £1LI i tf 'w�' FlC'c_. 1 1� t L yi l t ] ci I -iF ` E i, . k��y*(( i JF } i hhrG'(��aCeS {61y IC k n S { Ew4 e ;, aEsl�tix Pti� t�� u5 .4�. �a r.4r . •ii r 5.503.1 Install only a direct -vent sealed -combustion gas or sealed wood- El fireplace or a sealed woodstove and refer to residential requirements in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase If `6 emission limits. '�" !"! ❑ 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component ❑ openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 6,604.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks, Adhesives and sealants used on the project shall meet the requirements of the following standards, 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or ❑ SCAQMD Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid El shall comply with statewide VOC standards and other requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall ❑ comply with Table 5.504.4.3 unless more stringent local limits apply. 5.504.4,3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on use of ❑ certain toxic compounds and ozone depleting substances (CCR, Title 17, Section 94520 et seq). 5,504.4.3.2 Verification. Verification of compliance with this section ❑ shall be provided at the request of the enforcing agency. 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards IV<❑ listed in Section 5.504.4.4. 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute ElGreen Label program. 5,504.4.4.2 Carpet adhesive. All carpet adhesive shall meet the ❑ requirements of Table 5,504.4,1. Page 6 of 9 C U P E RT I N O CalGreen Non -Res Cheddist.doc revised 01123114 131 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for ❑ formaldehyde as specified in Table 5,504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section shall be provided as requested by the enforcing agency. Documentation shall include ahea§t one of the following standards listed in Section 5.504.5.3, 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one �tx �l of the following standards listed in Section 5.504.4.6, 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced ❑ by ordinances, regulations or policies of any city, county, city and county, California Community College, campus of the California State University or campus of the University of California, whichever are more stringent. t �.1� � 5,505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203 �V ❑ and Chapter 14.1. A�rrQualriy+and�halast ti , 5 ; RP,Y ty;,k s t , .3.,_ : _ _ _ 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with demand control ventilation, CO2 sensors and ventilation controls shall be latest specified and installed in accordance with the requirements of the edition of the California Energy Code, CCR, Title 24, Part 6, Section 121(c).' t� r;; .. �, r J� _71U7 i 1 ik vilronrrteq-al Comfdrt 7 i 4 k # t EY �- i 7 F SL EF h1 } �1=n77 5.507.4 Acoustical control. Employ building assemblies and components Where applicable ❑ with STC values determined in accordance with ASTM E 90 and ASTM E 413. 5.507.41 Exterior noise transmission. Wall and floor -ceiling assemblies making up the building envelope shall have an STC of at least 50 and Where applicable exterior windows shall have a minimum STC of 30 for any of the building ❑ locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4.2 Interior sound. Wail and floor -ceiling assemblies separating Where applicable tenant spaces and tenant spaces and public places shall have an STC of ❑ at least 40. Page 7 of 9 C U P E RT I N O CalGreen Non -Res C6ecklist.doe revised 01/23/19 131 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16 ��w 5t � - kr-?,... ..r. kft�l,y21 � � 4.: �.. 5}'i`«��'r§iii, .iF .,'•.it-,t.,.is �t-5 .::?4 pct`-r','l�;�cc i x,.:.�'ry �-i-S�L.�l� a._.f�',i t �4 `tF `-f i,i%:.i�F zrr. .. h' _':..—•....l.i 1 f L .... 4 _..... ,..r .. .. ... ,i ';:...«.1�. 5.508.1 Ozone depletion and greenhouse gas reductions. Installat7o?fHVAC, refrigeration and fire suppression equipment shall comply with 5,508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration jA. equipment that does not contain CFCs. 5.508.1.2 Halons. Install fire suppression equipment that does not contain ❑ Halons. Page 8 of 9 C U P E RT I N O CalOreen Non -Res Checklist. doc revised 01123114 131 Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16 CALGREEN SIGNATURE DECLARATIONS Project Name: k i P_ r-3(ock. Project Address: !i OtjS 0 L} 0Me_8k/(, 6( Project Description: SECTION I - 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 by the City of Cupertino. Owner's SignatureDate �,r / 511, ;, q-, e, 5 4 q ,�'� �� . -��4 / �s Z,-4 A � Design Professional's Signature Date uer Design Professional's Name (Please Print) A U d 4 �,eanga, 9/12/16 Signature of License Professional responsible for CalGreen compliance Date Paul Correa 650.269.: Name of License Professional responsible for CalGreen compliance (Please Print) Phone Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have 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 bate Name of License Professional responsible for CalGreen compliance (Please Print) Phone Address for License Professional responsible for CalGreen Page 9 of 9 C U P E RT I N O CalGreen Non -Res Checkllst.doc revised 01123114 �0"l Building Department REVIEWED FOR CODE COMPLIANCE Reviewed By:ArnOld HOm Date: 09/13/16