080601180C
FV.
a>_
oz
U
OF
' U
U
CITY OF CUPERTINO
PERMITCrU
iTItAC�TQR�IN�,,
13UILDINGIDIVISIOPF
BUILq+h8MESS:.AMBERLEY IN
l
ALL VALLEY PLUMBING
PERMITNO.
08060118
OWNER'S NAME:
PERMIT ISSUE DATE
CHARLOTTE HARANGHY
3345 SELDON CT
06/17/2008
NE:
SANITARY NO. CONrROLNO.
ARCHn (ENGINEER:
WATR HEATR REPLCMNT
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O O O O
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hamby allies that I am limned under pmHamas of Chapter 9 (commencing
with Section 7") of Division 3 o die Buunev And wm And my license is
'
�Pfrofevss.0
in full fet¢and eMCc.Y
License Cissa
Dam «moo--�
ARC TS DE
DECLARATION
all W mail
I uedersmnJ my pees shall W used v wblic rucord.
Licensed Professional
OWNER -BUILDER DECLARATION
1 Wori affirm that 1 Am ucmpt from the Comoro Lkenm law for the
fallowing rwo.. (Suction Tin 1.5, Business and Professinm Calc: Any city or, ... I,
which requites A Permit to conamm, alms WPmw, demolish, or mpur any structure
prior to its issuance.alsumquins the applicant ransuchreirrith to rile a signed statement
he is liceved to the of the Centocorf lessee Law (Chapter 9
Sq. Ft. Floor Area
Valuation
that pmaant provisions
(commencing with Section 7(1 of Division 3 of the Business And Perm ions Code) or
that he u exempt tWmfmm and the bvu for the alleged evmptlom. Any violation of
APN Number
OccupancyT e
YP
Se tion 7831.5 by atry applicant for a pewit subjects the applicant m a civil pwhy of
mat team titan Tnw hundred dollars (Sesta
0 1, v owner of the pmputy, m my wployev with wags u dtaa sok compewdm,
Required Inspections
and Ne unots Buisr
a Com
of
Law doss not apply h in owner car
and ProfessionLicensor caw doesapply in n
and Rty.1m m Cade: The Canameme,
nd wto Nang&hu
Wilds«impow thmmnandwho
Amssuchwwkhansalfm
Aweemployes,providedthat acts ins
own employees. lastthe
hamwear
oedmlamm.offated
lasold nonir.
however. the ur impmwmeat 4salt within one yearw cm he owner-
Arid r
Wnam wits n.w dta beam of pmriae that Ins did tat beta «imPmw r« wmam or
anise the
0 1. As awes of the property. Am aelusinelY conuacdog with licensed mntracma to
com tact the project (Sec. 70aa. Business and Professions Coda:) The Cona.cmla U.
.
cane law does not apply to an oww of Properly who Wilda or impmw themon. and .
wbo conmaca for such arm cm with A commicam(s) licensed prom m, m the Canaamofs
License Law.
O lomcaemptundurSee .B&PCfmduj.
Owner Data
WORKER'S COMPENSATION DECLARATION
I Wreby Allmon under penalty of perjury one of the following declandans:
1 haw and will maintain ACerdfim m ofCommmt In elf-imum for Wafte.
As provided for by Succor, 3780 of the Labor Code, for the performance of me
wart for which his Permit is issued.
❑ I haw and will maintain Worker. Compem.ion Insurance, As required by Section
37W of tW labor Cede. for the perfommee of the wok for which this permit u issued
'
My Worker's C.normuaGm Inmraox oaie and Policy numb« are:
Carrier. Policy No.: ,16469'Z0.3` 0J
CERTIFICATE OF EKEMP11ON FROM WORKERS
COMPENSATION INSURANCE
(Thu section need net W campicmd B the Permit is fortune hundred dnmm ($IW)
m loco)
1 certify hat in he perfomesuce of the work f« which this permit u issued I shall nuc
employ any person in any manner an as m become subject to the Workere Compensation
Laws or Calilomla Dam
Applicant
NOI7CE TO APPLICANT: If. after making this cmuncata of Esemption, you should
become subject to he Worker's Compcnsidan pmviAmos of he laWr Coda you most
forthwith comply with such pmriumu At this permit shall se deemed rawked.
CONSTRUCTION LENDING AGENCY
1 Wreby.111. deal here is A covtructinn kmduS agency for the pc,i.e. of
the wart for which this permit Is issued (Sec. 3097, Civ. C.)
Lander'. Name
Lenders Address
I canary hal 1 haw read this application And sum that the show inlmmadm is
corsccL i agree h comply with JI city and county ordinances and shta laws mlating to
building commocirm, and bemby &.Node re msentadvet of this city at enter upon tW
above-mcotio ed prgcmy for inspection parymea
(We) agree to taw, indemnify and keep hatmlev the City or Cupertino against
liabilities, judgments, casts and..Pe•... which may in anyway amus agumt suit City
in cocxqu race of the tranaat of this permiL
APPLICANT' UNDERSTANDS AND WILL COMPLY WITH ALL NON -P INT
,+
Issued by: Date
SOURCE�°°�T�ora�
®— J C
Re -roofs
-
Signature of pplian✓Conaxtor Date
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant or future Wilding «cupmt store or handle humdoes material
erioad by the Cupertino Municipal Codc. ChAptar 9.12, and the Halts and Safety
de.Section 255324)7
t]Y. LIN.
i
All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or fume Wilding msupam taw cyuipmem or Jcvies which
If a roof is installed without first obtainin an ins ection, I a ree to remove
g P gD�cmardnns
air cwmmimo s v &rued by me Bay Ara Air Quality Management
all new materials for inspection.
QYa
-
/ON. �
I haw mW the hvbJoAaMAu! "al .m: mmew under Chapter 6.95 Ards, Califar-
ma Health & SafctyCodc, Smtiou 2550.5, 25533 am12553y.l underswd heir the Wilding
Jos tat currently haw maanl Lou it a my respamiNlity m Muir he accuser of he
mquimmcmu moabeetpriortnumuccofacmificamaraca�/
" -r 0�
Signature of Applicant Date
All roof coverings to be Class `W or better
Owner car mthomm0 ogee Dam
• 4 ITEMS OF 4
•
•
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 34242014.00
DATE ISSUED.......: 06/17/2008
RECEIPT #.........: BS000005134
REFERENCE ID # ...: 08060118
SITE ADDRESS .....: 10236 CAMBERLEY LN
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
AMOUNT
---------------
106.56
---------------
106.56
VOICE ID DESCRIPTION
-------- ----------------------------
518 WATER HEATER
REFERENCE NUMBER
--------------------
#1353
VOICE ID DESCRIPTION
-------- ----------------------------
OWNER ............:
CHARLOTTE HARANGHY
ADDRESS ..........:
10236 CAMBERLEY LN
CITY/STATE/ZIP ...:.CUPERTINO
CA, 95014-2633
RECEIVED FROM ....:
ALL VALLEY PLUMBING
CONTRACTOR .......:
MARY SANDBRINK LIC #
23015
COMPANY ..........:
ALL VALLEY PLUMBING
ADDRESS ..........:
3345 SELDON CT
CITY/STATE/ZIP ...:
FREMONT, CA 94539
TELEPHONE ........:
(510)376.-4816
FEE ID
----------
UNIT QUANTITY
-------
AMOUNT PD -TO -DT
THIS REC
NEW BAL
1BSEISMICR
--- -
VALUATION 400.00
--------------------
0.50 0.00
----------
0.50
----------
0.00
1PPERMITFE
FLAT RATE 1.00
40.79 0.00
40.79
0.00
1PRWHEATR
UNITS 1.00
24.48 0.00
24.48
0.00
ITRAVDOC
FLAT RATE 1.00
40.79 0.00
40.79
0.00
TOTAL PERMIT
---------- ----------
106.56 0.00
----------
106.56
----------
. 0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
AMOUNT
---------------
106.56
---------------
106.56
VOICE ID DESCRIPTION
-------- ----------------------------
518 WATER HEATER
REFERENCE NUMBER
--------------------
#1353
VOICE ID DESCRIPTION
-------- ----------------------------
17
0
,�o(
CITY OF CUPERTINO 0,
1WATER HEATER
! ofFORM
CLIPEkTINO PERINUT APPLICATION
Date:
BIui'din2 Address:
P
Narne.
6/o
LZ�Lcz-a
Phone
oniracwt.
Fax �5to--L,6 -� L:7�7/
uT)eriino jhs-MCsS License:
Phone ;3bf
Contact:
Fay #:
i I d ir P. Per
it info:
jZ C,' z3 1 e., eT 16al 72
Descripncm
Elc�ct Plumb
4e
Strapped Piatfb-m Bonded
\eraLocation Repiacement
Check must be completed and attached to this application
Green Building Points achieved:
• CUPEf�TINO
49
0
CITY OF CUPERTINO
WATER HEATER
PERMIT APPLICATION FORM
Quantity
Fee 10D
Fee Description
Fee
Group_
Permit Type
1PCWHEATR
Commercial Water
HeaterNent
B
PCWHEATR
1BSEISMICOM
Seismic Commercial
B
/
I
1PRWHEATR
Residential Water
HeaterNent
B
PRWHEATR
1BSEISMICRE
Seismic Residential
B
1PPERMITFEE
Plumbing Permit
P
/
1TRAVDOC
Travel &
Documentation
B
1BUSLIC
Business License
B
•
•
•
Single Family GreenPoint Checklist date: 7(23
he Gre rrPom, Checklist is based on the various green isatures incorporated into the home and is the
basis for the GreenPoint Rated program. A home_ can ba considered green d it fulfills the prerequisites.
Dams at least 50 points, and meets the minimum points per categoy. Enargy (30), Indoor Air Quality/
HeaVh (5), Resources (6), and Water (9). Reass can as Build Il Green for a list of qualified GreanPoint
Raters if you are interested in pursuing third -party verification.
The green building practices listed below are dsoribad in the Ne_w Home_ Cniorustion Grean Building
Guidelines, available at www.bi ldifor=_en ora.
Build ItCre-a
Smart Solutions From The Ground Up
02007 Build It Green
Single Family GreenPoint Checklist 2007 Version
Page 1 of 4
o w c Sic
.A SITE $ pM. — PDinis Availal]IE Pzt Ivtaesurz
1. Prtect
oTopsoil and Minimize Disruption of EzisGng PI s &Tress
❑ a proton TapscB from Erosion and pause alter CDenuetion
❑ b. Lima and Conran CDnatnrDI Footprint for Minimum Protection
I 2 Deronstruq Instead of Demolishing Existing Buildings On Site
3
3. Recycle Job Site Construction Waste (Including Green M'este) I
❑ a. Idinimum 50% Waste Diversion by Waight(da:yatg wirtin)-Raguira.Y 0
R
❑ b. Minimum 65% Diversion by Weight (Recycling or Reuse) - -- -
El C. C. Idinimum BD% Diversion by Weight (Recycling a Rause) 2-
4. Use Recycled Content Aggregate (Minimum 25%)
❑ a. Walkway, and Driveway
❑ a Roadway Sass
Tonal Points Availabls in Sile=12
B. FOUNDATION
1. Fint.e Portland Cement in Concrete with Recycled Flyash or Slag
it Par,!, Availablz Par Measu2 j
j wL II 1 I /((
❑ a Minimum 20% Flynn a Slag
3
1
El b. Minimum 25%Flyash or Slag
1
0
2 Use Fo.st-Protacted Shallow Foundation n Cold Areas C.E.C. Climate Zone 16)
3
j ❑ 3. Use Radon Resistant Construction On At -Risk Locations Only)
4. Design and Build Structural Peat Controls
0 1
❑ a. Install Tornio- ShieldSeparate All Exterior. Wcar-toConcre'x Conlectons by Mini or Renc Fast .ID''tl ws
I
-
rel b. All New Plants Have uunicone or Stem Located At Least 3Inches H tlh
Total Points Available m Foundation a 81
0
j
C. LANDSCAPING
I . Construct ResouredEfficient Landscapes
Points Available Pal Id=asua
El a. a. No Invasive pied=- listed C Are planted
p
j
El h. NO Plant Species Wil Requirere Hsdging
Hedgi
❑ C. 75% of Plarrs Are Drought -tolerant Call ors Natives, Id=cirartanaan, a Other AppmFn3 a Species
❑ 2. Use RunSafa Landscaping Techniques
D
3
3. Minimize Turf Areas in Landscape Installed by Builder
❑ x. AU TDI Will Have a N'atxr Requirement Less than on Equal to Tao Fescue (50.9 prem faao0
n
D
-
❑ b. Turf Shall Nm Be Installed on Slopes Exceeding l0% a in Areas Less Nan B Feet Wide'-'-""'
❑ c. Tutl is S'3% DI Landscaped Area (tYal2 pains)
D
----_--
El c. C. Turf is 510% C Landscaped Area (had 4 pains)
..-0 .
F _-- - -- -
❑ 4. PlantShade Trees
-
0
I—
❑ 5. Group Plants by Weer Needs (Hydrozoning)
(! 3
S. Install High -Efficiency Irrigation Systems
0
]
❑ a. System Uses Only Lew -Flow Drip, Bubblers, or Low -flow Sprinklers
0
1 --'- 2
��'-_�r/
❑ b. System Has Smart Controlers
❑ ]. Incorporate Two Inches of Compost in the Top 6 to 12 Inches of Soil
0
3
❑ 6. Mulch All Planting Beds to the Greater of 2Inches or Local Water Ordinance Requirement
0
(( ) 3
9. Use 50% Salvaged or Recycled -Content Mat^rials for 50% of Non -Plant Landscape Elements
D
`-� z
❑ 10. Reduce Light Pollution by Shielding Figures and/or D"recfng Light Downward
D
—�
Total Pans Avail able in Lancscaping-311
'D. STRUCTURAL FRAME & BUILDING ENVELOPE
0
D
1
1. Apply Optimal Value Engineering
Paints Avail:bl2 Pa ure
❑ a. Place Rafters and SNds at 24 -Inch On Canter Framing
0 I
,
E) b. Size Doth and Window Handers is Load �
❑ c. Use Only Jack and Cripple SNds Required for Load
- -
se
2. UEngineered Lumber
O
❑ a Seams and Headers
❑ b. Insulated Engineered Headers
❑ C. WDDd I Joists or Web Trusses for Floors
- 0
❑ J. Wood Wipers fa.RDol Railer-
-
❑ e. Engineered or FingarvJoinled 6NC5 for Vertical Applications -
0
❑ 1. Oriented Strand Board fa Suhiloor
!
❑ g. Oriented Stand Board for Wall and Root Sheathing
3. Use FSCCsrtified Wool
0
- 1
❑ e Dimensional LumSer, Studs and Timber Minimum 4D'.
'
- - -I
_J
❑ b. Dimensional Lumber, Studs and Tmbec Idinimum 70%
❑ C. penal Predl Idinimum 4D%
p
-_
❑ d. Panel Products: Minimum 70%
D I
_
j
02007 Build It Green
Single Family GreenPoint Checklist 2007 Version
Page 1 of 4
•
•
Is t i
m
4. Use Solid Wall Systens (Includes SIPS ICFs, 6 Any NortSbck Frame Assembly)
t
❑
a. Floors
p_._�
❑
b. Walls
-p
2
El
c. Roofs
0
2 -
5. Reduce Pollution Entering the Home from the Garage
❑
a. Tighly Seal the Air Barrer between Garage and Living Area
❑
b. Insall Garaoe Exhaust Fan OR Build a Detached Garage
D
_
6. Design Energy Hat on Trusses (7% of Attic Insulation Height M Outside Edge of Exterior Well)
0 j
1
❑
. 7. Design Roof Trusses to Accommodate Ducenork
0
1
Lj
9. Use Reoyeled-Content Steel Studs for 80% of Interior Wall Framing
I 0
1
9, Thermal Mass Walls: SfIt4neh Drywall on All Interior Walls or Walls Weighing more than 40Ilucu.fl.
0
1
10. Insall Overhangs and Guders
_
❑
a. Minimum lblnch Overhangs and Gutters
p
❑
b. Minimum 24 -Inch Ovemanos and Gutters
p
_ - -
Total Points Available in Stmctufal Running Frame and Envelop = 361
0
I
;E. EXTERIOR FINISH
P01o1E 44IRble Pa; M-aSLre
on
fl°.ydetlContent (No Virgin Nestle) or FSC -Certified Wood Decking
0
I Z
2. Insall a Rain Screen Wall System
p
2
D, Use Durable and Noncombustible Siding Materials
0
1
1. Seled Durable and Noncombustible Roofing Materials
0
Z
Total Poins Available in Exshor Finish = 7
0
,F. INSULATION
I
I Ppiois Awailad?Pet ldaasu2 I
1. install Insulation with 75% R"cled Conant
❑
a Walls andfor Fibers
-
❑
b. Ceilings
...
I
2. Install Insulation that is Lew-Emining (Certified Section 01350)
❑
a. Walls ancifm Floors
0
1 I
F-1
—M-3.
b. Ceilings
0
Inspeq Oualiry of Insulation Insallabbn before Apptying Drywall
0
I 1
Toal Points Available in Insulation = 51
0
IG. PLUMBING _
1. Distribute Domestic Hot Water Efficiently (Maximum 7 Points) .
Point= Available Per Me=_;ur?
❑
a. Insulate Hot Water Pipes from Water Harper to Kitchen
0
0
I I
---- - .. _
❑ b. Insulate Al Hol Water Pipes-----
❑
C. Use Enginaeratl Parallel Piping-
i
❑
d. Use Engineered Parallel Piping with Demand Controlled Clmusfibn Loop
0
❑
e, Use Structured Plumbing with Demand Controlled Ciroutation Loop
❑
f, Use cental Core Plumbing
- - - -- -
❑
2. Insall Only High Efficiency Token (DuaWlush or Sl.20 gpf)
0 t
G
-H.
io'al Poins Av'Idela in Plumbing Total 121
D
HEATING, VENTILATION ffi AIR CONDITIONING -
r0i01s AvallabL Per IJ�aasure
❑
1, Design and Insall HVAC System to ACOA Manual J, D, and S Recommendations
j
2. Insall Sealed Combustion Units
0
❑
a. Fumeces
0
❑ b. water Heaters
3. Insall Zoned, Hytlronic Ratlianl Heating with Slab Edge Insulation
0
4. Insult High Efficiency Air Conditioning with Environmentally Reeponsiba ReMgerans
D �
1 1
5. Design and Insall ERective Ductwork -
D i
1
❑
a. Instal HVAC Unit and Ductwork within ObndAioned Space
❑ b. Use Duct Mesio on At DueL Joins and Seams
❑
c. Instal Ductwork under Attic Insulation (Barad Dints)
�
❑
d. Pressure Balance the Ductwork System
0
❑
e. Protect Duct; during Construction and Clean All Ducts before Occupancy
-
- -- - -- .
6. Insall High Efficient' HVAC Film(MERV 6t)
❑
7. Don't Insall ,:e or Install Sealed Gas fireplaces with Efficiency Rating Not Lees Than 6D%
D j
1
using CSA Sandards
p
I
I
6. Insall Eflsctive Exhaust Systems in Bathrooms and Kitchens
❑
a Instal ENERGY STAR Bathroom Fans Vented to the Outside
p
---- l-
—
1
❑ b. All Bathroom Fans Are on Time. or Humidisal
EJc.
Instatl Kitchen Range Hood Vented to the Outside-
{-
9. Install Mechanical Ventilation System for Cooling (Mazimum 4 Poins)
p
I
❑
a. Instal ENERGY STAR Ceiling Fans 6 Light Kits In Living Areas A Bedrooms
❑ b. Install Whole House Fan with Variable Speeds-
❑
c. Automatically Controlled Inlagraled System
❑
d. Automatically Controlled Integrated System wilt Vanable Speed Control
10. Insall Mechanical Fresh Air Ventilation System (Maximum 3 Points)
t
❑
a Any Whole House Ventilation S)slem Tha; Meets ASHRAE EZ
D
❑ b. Install Fir -Io -Air Heat Exchanger (nal mees ASHRAE 522
11. ins all Cation Monbxitle Alartn(s)
0
i 2 I
D I
Total Points Available in Heatin,Ventilatibr,, and Air Cbndlianing=37
D
,a -
-Xk
CITY of
O.JPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
I am not using any subcontractor . '
Signature Date
Please check annlicable subcontraq6rs and com Tete the followin information
W
Owner/ Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
W
Owner/ Contractor Signature
Date