08060180aYa1t�c
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CITY OF CUPERTINO
BUILDING DFVISION PERMIT
CONTRACTQRIIVIF'O'RMATION
A'. ,
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BUIL 1 A RESS:
�Q/gS TUGGLE AVE
AMERICAN RESIDENTIAL
PERMIT NO.
08060180
OWNER'S NAME:2,M�TeEs
OF CA
PERMIT ISSUE DATE
CARL TITSWORTH
5100 POPLAR AVE STE 3000
06/24/2008
NE:
SANITARY NO. CONTROL NO.
(408) 982-0405
ARCHITECTIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMBMECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
o
t 1 licensed under provisions of Chapter 9 (commencing
1 hereby affirm Wam
with Section 7000)o(DiAsion Sof the Business and Pmfess(ons Cade. and my license is
REPLC APPRX 25FT SEWR PIPE & PROPTY LINE CLEAN
in full farce and alfcct
License a Lic'
UT
DateCo.--
ft cHmzcrS IECL4A
1 understand my plans shall W used as Public meow
Licensed Pvfcssiadal
OWNER -BUILDER DECLARATION
I hereby aRsm that 1 am exempt from the Conlracars Idecnse Law for IM
following mason. (Section 703 1.5, Business and Prefesuov Code: Any city or county
which tequirrs • permit m eanswe4 alter, bre mw. dcmol"'. or moor any someone
! Prieto) its issuance,almoo,uims de applicant forsuch Pennine file asignedsummrnt
thuhaislicevetl Ne of the Conuactu/s Limnx law (ChaPtn9
Sq. Ft. Floor AreaValuation
Pursuantm provisions
6 000
(cammeving with Section 7000)of Division Sof rite eunneumd Promsiov Cade)ar
1
I me oru Iefrom and rite buffs for the alleged exemption. My violation of
that he is Mr
37527022.ENumber
Oeeu ane -Typesection
7031.5 by any applicant for a permit nbms the applicant to a cm] Penalty of
tet mom dun fm hundred dnllm(M),
1. a owner of the property, or my employees with wages u theor sole compensation,
will do Ihcworit. and the sternum u not Intended or offered for sale (sec.7WA, BuuM••
Required Inspections
and Pmfessiom Code: The Cmuscmrs License Law dors not apply In an owner of
property who Wildaorimproves thereon. andwho does suchworkhimselfor through his
awn employees. provided out such imprommcots a e not intended accrued (resale. B,
however, the Wilding or improvement Is sold within one year of completion, the owner.
Wilder will have the burden of proving that he did tet Wild or improv for purpose of
sale.).)y1,
('`tlg➢ITAR
u awnsof te yropony, aro exclusively contracting with licensed comacmes mWooster
AN
the project (Sec. 7044. Businev aha Professors,Cade) The Con tide's Li-
cave law dors not apply to an owner of propcny who Wilds or improves thereon, and,
whocontracu for such pmjecu with r
a codactea the Rs) licensed personm Contrano's
License law.
❑1turnexemptundmsec. ,B&PCfarthismaaan
Ownu Data
WORKERS COMPENSATION DECLARATION
1 hereby aRrso under perafty of perjury one of the following declassuons:
1 hem and will mnnuin a CertiOam of Cement selFivum for Wm1m,'a Compen-
sation, as provided far by Secuon 3700 of the labor Code, for the peAomunce of the
,
wart for which this permit u issued
❑ I lune and will maintain Workeh Compensation Insurance, as required by Second
3TOpof the laWrCade. for the pedmmumeaftie work forwbwh this Part issued
'
My Wm s Comped tion Iwraue artier and Policy number are:
Coni Polity
/
3f
CE IFl TE EXEMPTIONFROMWORKER
FROM
0
COMPENSATION INSURANCE '
(Ttissecdm decd notbecompleted ifthe permit Is foreme hundred dollars(glop)
or Rus)
I certify that in the performanu of the work for which this Permit u issued, I shall not
employ any pcoma In my mMaerm as an become subject to the Warkerl Gnmparro don
Laws of California Dau
Applicant
'
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject m the Workees Compensation provlsimu of the I.abv Cade, you mus
forthwith comply with such prn,mmat or this permit dull be darned mooted.
cohimucT10N LENDING AGENCY
1 Wmby affirm that them u a cotuwctinn lending agency far the Pa femaae of
'
the work for which this permit is issued (Sec. 31197, Civ. C.)
Leader's Nene
Landers Addmu
1 call that 1 have road this applieatim aha sum Nat the dam, iofnom,no is
Callen I agree m comply with all city and county mdinLKss and su nd laws relating m
Wilding cownaction, and hereby mthodm repmscnwives of this city to enter upon tit
a Woe -mentioned Property far inspcctim purposes
(We) agree In save, Indemnify and kap harmless the City of Caperton, against
liabiliuea,ludgmcnu,cosu and expenses which may in my way ac,me against and City
id conteq of led "rutin" of this pummit
APPL A NDERSTAND AND WILL C Y WITH ALL NON -POINT
-4/ -
Issued by: Date �r
SOUR ,
ULATIof
G j —G
Re -roofs
Si ApplirmuCan Dale
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will rhe applicant or future building acupmtsmre m handle moordou material
as dclIned by Ne Cupenim Municipal Code, Chapter 9.12. and the Health and Safety
oak.anx5sux(.)7
0 Yes 42
All roofs shall be inspected prior to any roofing material being installed.
Will thea ficmt or more building coupon use equipment
Pp e P 9 proem or devices which
kcla
If a roof is installed without first obtaining an inspection, I agree to remove
g P
it us7 ns air conuminmas te di by the Bay Area Air Quality Mavm
gcenl
all new materials for inspection.
ct7
C3 Y. u
I ham mad the harstd smatenaH mquimmcou under Chapter 6.95 of the Califor,
nix FkalN&SnctyCodo x5515,x5533u 25534.Imdcrsmdthuifde building
Jou no rte Iy hane • unmt, Wt it is my responsibility m notify the a depart of the
mqu' nu hkhmustWm 'rtoissu oncamresteofoa`a
ignatureofApplicant Date
. All roof coverings to be Class'RW' or better
Owne m pried agent Date
• 4 ITEMS OF 4
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ......... 37527022.00
DATE ISSUED.......: 06/24/2008
RECEIPT #.........: BS000005203
REFERENCE ID # ...: 08060180
SITE ADDRESS .....: 18760 TUGGLE AVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER CARL TITSWORTH
ADDRESS ..........: 18760 TUGGLE AVE
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: patg
COPY # : 1
RECEIVED FROM ....: AMERICAN RESIDENTL
CONTRACTOR .......: DONALD KARNES LIC # 21504
COMPANY ..........: AMERICAN RESIDENTIAL SERVICES
ADDRESS 5100 POPLAR AVE STE 3000
CITY/STATE/ZIP ...: MEMPHIS, TN 38137
TELEPHONE ........: (408) 98270405
• FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
1BSEISMICR
VALUATION
6,000.00
0.60
0.00
0.60
0.00
1PPERMITFE
FLAT RATE
1.00
40.79
0.00
40.79
0.00
1PRSEWER
UNITS
1.00
20.40
0.00
20.40
0.00
1TRAVDOC
FLAT RATE
1.00
----------
40.79
0.00
40.79
0.00
TOTAL PERMIT
102.58
----------
----------
0.00
102.58
----------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
102.58
---------------
102.58
VOICE ID DESCRIPTION
-------- ----------------------------
106 SEWER & WATER
301 ROUGH PLUMBING
507 FINAL PLUMBING
•
REFERENCE NUMBER
--------------------
#8128004657
VOICE ID DESCRIPTION
-------- ----------------------------
202 UNDERFLOOR PLUMBING
400 SEWER/LATERAL
Ca -
CITY OF
• CUPERTINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
PERMIT APPLICATION FORM
o�?O & 0140
APN#275 c2-7 0,;�,;?. 0-0
Fee ID
)) /iing Add4? 19ress:
Owner's Name:
Phone
1PCSEWER
or:
CX9e4
Phone #: �/ Z
1CPSS
Fax #:
tact:
Phone#gip
1CPRP
Fax #:
Contractor License #: 7e5-/,5-5-
-/,5—Cu
Cupertino
ertino Business License #: 2��0
Job Description: )W*
y
Residential Commercial ❑
Valuation:
I9
Project Size: Express Standard ❑ Lazge ❑ Major
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Green Building Points:
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PCSEWER
Commercial building
sewer/sanitary sewer
P
1CPSS
IBPPREP—WE
Commercial re -pipe per fixture
P
1CPRP
1PGASCOM
Commercial Gas Piping System
1-4 Outlets
P
1BSEISMICOM
Seismic Commercial
p
I
1BSEISMICR
Seismic Residential
p
1PRSEWER
Residential building ---r
sewer/sanitary sewer
P
1RPSS
CITY o
CUPEkTINO
CITY OF CUPERTINO
REPIPE/SEWERIMAIN SERVICE
FEESCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PRREPIPE
Residential re -pipe per fixture
P
1RPRP
1BPWSVCS
Water Service
P
1CPWS or
1R -PWS
1PPRSEWG
Private Sewage Disposal System
P
IPCESS
Cesspool
P
1BPWATER
Install/alter Water Pipe
P
1BPFIXTURE
Plumbing Fixture
P
1PGASRES
Residential Gas Piping System
1-4 Outlets
P
IBPGAS
Gas Piping System 5+ Outlets
P
IPPERMITFEE
Plumbing Permit Fee Issuance
P
1PLMBLNCK
Plumbing Plan Check
P
1PLMBINSP
Other Plumbing/gas Insp.
P
/
1 TRAVDOC
Travel & Documentation Fee
B
1BUSLIC
Business License
B
Revised 6-16-08
40
•
0
•
•
Plan Review Process Work Book Page -12-Revised 3/25/08
Green Building Plan Check
Index of Green Building
Points/Categories
A.
Category
Example of an Index or Table of Green
Plan Sheet or Page
Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below _
2
B.
Site
9.
Install H.E. Irrigation, (details/spec)'
L-1
2 points
11.
Permeable Paving, Note
L-1
2 points
C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
5 points
D.
Structural
3.
Uses Wood I-Joist, (See Spec.)
S-2
2 points
5.
Use Truss with heels, (detail)
S-2
2 points
6.
B. OSB Sheathing, detail
S-2
2 Points
E.
Ext. Finish
1.
Composite Decking, (Note/Spec.)
A-3
2 points
4.
B. Fiber Cement Siding, (Note/Spec.
A-4
2 points
F.
Plumbing
1.
Insulate all H.W. pipes, (Note/Spec.)
P-1
2 points
5.
Tankless W.H., (Note/Spec.)
A-2
2 points
11.
A 2500 Gal. Tank, (Note/Spec
L-1
10 points
G.
Electrical
4.
E. Ceiling Fans, (Note/Spec.)
A-3
4 points
H.
Appliances
1.
Energy Star Dishwasher, (Note/Spec.)
A-3
1 point
3.
Energy Star Refrigerator, (Note/Spec.
A-3
1 point
P.
Other
1 1.
List Green Features on Plans
A-1
1 point
TOTAL POINTS1
40 points
•
•
Plan Review Process Work Book Page -12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types, assigning a'total points' value to a project to be considered environmentally friendly is •
not feasible. However, 25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for 'greening' your project.
1. Recycle Job Site Construction & Demolition.
aste
65%, =1 point; 75% 2 points; 80% =4 points
up to 4 Resource
2. Salvage Reusable Building Materials
4 Resource pts
y=
3. Remodel for Mixed Use, Adaptive Reuse, and
2. Use FSC Certified Wood for framing
Historic Preservation
4 Resource pts
y=
4. Protect Native Soil
2 Resource pts
y=
5. Minimize Disruption of Existing Plants 8 Trees
1 Resource pt
y=
6. Implement Construction Site Stormwater Practices
2 Resource pts
y=
7. Protect Water Quality with Landscape Design
2 Resource pts
y=
B. Design Resource -Efficient Landscapes and Gardens
4 Resource pts
y=
9. Reuse Materials/Use Recycled Content Materials
2 Resource pts
y --ye;
for Landscape Areas
2 Resource pts
y=
10. Install High -Efficiency Irrigation Systems
2 Resource pts
y=
11. Provide for On -Site Water Catchment / Retention
2 Resource ots
v=
B. Foundation
1. Incorporate Recycled Flyash in Concrete
25% Recycled Flyash = 2 points; Add 1 point for every 10%
increase of flyash, up to 5 points up to 5 Resource
2. Use Recycled Content Aggregate 2 Resource pts y=
3. Insulate Foundation/Slab before backfill 3 Energy pts y_
C. Structural Frame
r
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1. Substitute Solid Sawn Lumber with Engineered Lumber
3 Resource pts
y --yes
2. Use FSC Certified Wood for framing
(For every 10% of FSC lumber used = 2 points, up to 10)
up to 10 Resource pts
3. Use Wood ]-Joists for Floors and Ceilings
2 Resource pts
y --ye:
4. Use Web Floor Trusses
2 Resource pts
y=ye:
5. Design Energy Heels on Trusses 6' or more
2 Energy pts
y=yeE
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts
y=ye:
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=ye:
B. Use Recycled Content Steel Studs for Interior Framing
2 Resource pts
y --ye;
9. Use Structural Insulated Panels (Sips)
a. Floors
3 Energy pts
y=ye
b. Wall
3 Energy pts
y=ye
c. Roof
3 Energy pts
y=ye'.
10. Apply Advanced Framing Techniques
4 Resource pts
y=ye,
11. Use Reclaimed Lumber for Non Structural Applications
3 Resource pts
y=ye
12. Use OSB
a. Subfloors
1 Resource pt
y=ye
b. Sheathing
1 Resource pt
y=ye
•
•
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1. Install Energy -Efficient Windows
2 Energy pts
y=yes
• a. Double -Paned
1 Energy pt
y=yes
b. Low -Emissivity (Low -E)
2 Energy pts
y=yes
c. Low. Conductivity Frames
2 Energy pts
y=yes
2. Install Low Heat Transmission Glazing
1 Energy pt
y=yes
J. Heating Ventilation and Air Conditioning
1. Use Duct Mastic on All Duct Joints
2 Energy pts
y=yes
2. Install Ductwork within Conditioned Space
3 Energy pts
y=yes
3. Vent Range Hood to the Outside
1.IA0/Health pt
y=yes
4. Clean all Ducts Before Occupancy
2 IAQ/Health pts
y=yes
5. Install Solar Attic Fan
2 Energy pts
y=yes
6. Install Attic Ventilation Systems
1 Energy pt
y=yes
7. Install Whole House Fan
4 Energy pts
y=yes
B. Install Sealed Combustion Units
5 IAQ/Health pts
y=yes
a. Furnaces
31AQ/Health pts
y=yes
b. Water Heaters
3 IAQ/Health pts
y=yes
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps
3 Energy pts
y=yes
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
y=yes
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
y=yes
12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
yges
13. Retrofit Wood Burning Fireplaces
10 Energy pts
y=yes
• a. Install EPA certified wood stoveslnserts
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
4 IAQ/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3 IAQ/Health pts
v=ves
K. Renewable Energy and Roofing
1. Pre -Plumb for Solar Water Heating
4 Energy pts
y=yes
2. Install Solar Water Heating System
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
4 Energy pts
y=yes
4. Install Photovoltaic (PV) System
(1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw =16 points)
Up to 15 Energy pts
6. Select Safe and Durable Roofing Materials
1 Resource pt
y=yes
7. Install Radiant Barrier
3 Energy pts
y=yes
L. Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts y=yes
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
0
r a, Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
CITY OF Fax (408) 777-3333
*UPERTINO
Building Department
n
U
I am not using any subcontractors: �
pff�
Signature Date
Please check applicable subcontractors and complete the following information:
JOB AD.
v 41 ,s
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
RMA
n
U
I am not using any subcontractors: �
pff�
Signature Date
Please check applicable subcontractors and complete the following information:
Contractor
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
Contractor